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Cited by 252Endometriosis Research and TreatmentEctopic Pregnancy Diagnosis and ManagementMenstrual Health and Disorders

Patients’ report on how endometriosis affects health, work, and daily life

Open access
Fourquet, Jessica, Gao, Xin, Zavala, Diego, Orengo, Juan C., Abac, Sonia, Ruiz, Abigail, Laboy, Joaquín, Flores, Idhaliz·2010·Fertility and Sterility
DOI 10.1016/j.fertnstert.2009.09.017PMC PMC2860000
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Abstract

NARRATIVE ABSTRACT The objective of this study was to assess the burden of endometriosis by obtaining Patient Reported Outcome (PRO) data describing the experience of living with this disease. Survey data from one hundred and seven women with self-reported, surgically diagnosed endometriosis showed that living with this disease may be characterized by physical limitations that disrupt health, work and daily life.

Integrity signals

Registry

Crossref · 10.1016/j.fertnstert.2009.09.017

Cites

53 of 53 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 59 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    In 107 women with self-reported surgically diagnosed endometriosis, living with the disease was characterized by physical limitations that disrupted health, work, and daily life.

    “Survey data from one hundred and seven women with self-reported, surgically diagnosed endometriosis showed that living with this disease may be characterized by physical limitations that disrupt health, work and daily life.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The anonymous patient-reported outcome instrument used in the survey validly measures the impact of endometriosis on daily life and work.
    • Rests on an assumption: Patients' self-reported surgical diagnosis of endometriosis is accurate.
  • Findingown data

    The mean delay in diagnosis was 8.9 years (SD ± 7.9).

    “The mean delay in diagnosis in these subjects was 8.9 years (SD±7.9).”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The anonymous patient-reported outcome instrument used in the survey validly measures the impact of endometriosis on daily life and work.
    • Rests on an assumption: Patients' self-reported surgical diagnosis of endometriosis is accurate.
  • Findingown data

    Symptoms began during adolescence (11-19 years old) for most patients.

    “Symptoms started during adolescence (11-19 y/o) for the majority of these patients.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The anonymous patient-reported outcome instrument used in the survey validly measures the impact of endometriosis on daily life and work.
    • Rests on an assumption: Patients' self-reported surgical diagnosis of endometriosis is accurate.
  • Findingnone given

    The majority of responders were well-educated women.

    “Also of note, the majority of responders were well-educated women.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The anonymous patient-reported outcome instrument used in the survey validly measures the impact of endometriosis on daily life and work.
    • Rests on an assumption: Patients' self-reported surgical diagnosis of endometriosis is accurate.
  • Findingcitation

    These absenteeism rates are higher than those reported for other pain conditions such as headaches, arthritis, and back pain.

    “These absenteeism rates are higher than those reported for other pain conditions such as headaches, arthritis and back pain (39).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [39] Stewart, 2003, Lost productive time and cost due to common pain conditions in the US workforce, JAMA source

      Not checked in the free run.

    • Rests on an assumption: The anonymous patient-reported outcome instrument used in the survey validly measures the impact of endometriosis on daily life and work.
    • Rests on an assumption: Patients' self-reported surgical diagnosis of endometriosis is accurate.
  • May combine two claims. 22
  • Classified as probably not a substantial claim. 15

  • May combine two claims.

    Findingown data

    All patients were symptomatic, and 72% reported at least eight endometriosis-related or coexisting symptoms, with dysmenorrhea, incapacitating pain, and dyspareunia most common.

    “All patients in this study were symptomatic and 72% reported having ≥8 endometriosis-related or coexisting symptoms, being dysmenorrhea, incapacitating pain, and dyspareunia the most common (Table 1).”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The anonymous patient-reported outcome instrument used in the survey validly measures the impact of endometriosis on daily life and work.
    • Rests on an assumption: Patients' self-reported surgical diagnosis of endometriosis is accurate.

  • May combine two claims.

    Findingown data

    Three patients reported being totally incapacitated, and three were dismissed from or quit their jobs due to symptoms.

    “Three patients reported being “totally incapacitated” and three were dismissed from or quit their jobs due to symptoms.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The anonymous patient-reported outcome instrument used in the survey validly measures the impact of endometriosis on daily life and work.
    • Rests on an assumption: Patients' self-reported surgical diagnosis of endometriosis is accurate.

  • May combine two claims.

    Findingown data

    Patients with menstrual pain (OR=22.8, 95%CI 2.3-226.7), incapacitating pain (OR=35.2, 95%CI 4.3-274.6), depression (OR=17.2, 95%CI 2.2-142.9), and abdominal pain (OR=5.2, 95%CI 2.3-226.7) were more likely to report that their work (at home and professionally) was affected by endometriosis.

    “Patients with menstrual pain (OR=22.8, 95%CI: 2.3–226.7), incapacitating pain (OR=35.2, 95%CI: 4.3–274.6), depression (OR=17.2, 95%CI: 2.2–142.9), and abdominal pain (OR=5.2, 95%CI: 2.3–226.7) were more likely to report that their work (both at home and professionally) was affected by endometriosis.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The anonymous patient-reported outcome instrument used in the survey validly measures the impact of endometriosis on daily life and work.
    • Rests on an assumption: Patients' self-reported surgical diagnosis of endometriosis is accurate.

  • May combine two claims.

    Findingown data

    65% of patients had never suspected endometriosis and had never heard of the disease before surgery.

    “In our study, 65% of patients had never suspected having endometriosis and had never heard of the disease before surgery.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The anonymous patient-reported outcome instrument used in the survey validly measures the impact of endometriosis on daily life and work.
    • Rests on an assumption: Patients' self-reported surgical diagnosis of endometriosis is accurate.

  • May combine two claims.

    Findingown data

    The majority (71%; n=76) of patients had tried to get pregnant, and 90% of them (n=68/76) reported problems conceiving.

    “The majority (71%; n=76) of patients in this study have tried to get pregnant, and 90% of them (n=68/76) reported having problems conceiving.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The anonymous patient-reported outcome instrument used in the survey validly measures the impact of endometriosis on daily life and work.
    • Rests on an assumption: Patients' self-reported surgical diagnosis of endometriosis is accurate.

  • May combine two claims.

    Findingown data

    The proportions reporting that symptoms affected specific daily activities were: household chores 79%, sexual relationships 71%, work 66%, appetite 54%, exercise 56%, sleeping 54%, and social activities 48%.

    “Many felt physical limitations to conducting day-to-day tasks, such as household chores (n=84, 79%), sexual relationships (n=76, 71%), work (n=71, 66%), appetite (n=58, 54%), exercise (n=60, 56%), sleeping (n=58, 54%), and social activities (n=51, 48%).”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The anonymous patient-reported outcome instrument used in the survey validly measures the impact of endometriosis on daily life and work.
    • Rests on an assumption: Patients' self-reported surgical diagnosis of endometriosis is accurate.

  • May combine two claims.

    Findingown data

    Among patients who had heard of endometriosis before surgery, 14% (n=15) heard through media and 8% (n=9) through a friend or family member.

    “Those who had heard about the condition did so through the media (n =15, 14%) or a friend/family member (n=9, 8%).”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The anonymous patient-reported outcome instrument used in the survey validly measures the impact of endometriosis on daily life and work.
    • Rests on an assumption: Patients' self-reported surgical diagnosis of endometriosis is accurate.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Seven out of ten participants were nulliparous.

    “Seven out of 10 participants were nulliparous.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The anonymous patient-reported outcome instrument used in the survey validly measures the impact of endometriosis on daily life and work.
    • Rests on an assumption: Patients' self-reported surgical diagnosis of endometriosis is accurate.

  • May combine two claims.

    Findingown data

    Almost all participants (96%) had private medical insurance, which generally covered surgical procedures (93%) but not medical treatments (50%).

    “Almost all (96%) of the participants had private medical insurance, which generally covered surgical procedures (n=117/126, 93%), but not medical treatments (n=108/214; 50%).”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The anonymous patient-reported outcome instrument used in the survey validly measures the impact of endometriosis on daily life and work.
    • Rests on an assumption: Patients' self-reported surgical diagnosis of endometriosis is accurate.
    • Rests on an assumption: In Puerto Rico, health insurance companies generally do not cover contraceptive drugs or infertility-related treatments and procedures.

  • May combine two claims.

    Findingown data

    Most patients characterized their pain as non-menstrual and reported that pain interfered with daily life activities (incapacitating pain).

    “Most patients characterized their pain as non-menstrual (NP) and reported that pain interfered with their daily life activities (IP).”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The anonymous patient-reported outcome instrument used in the survey validly measures the impact of endometriosis on daily life and work.
    • Rests on an assumption: Patients' self-reported surgical diagnosis of endometriosis is accurate.

  • May combine two claims.

    Findingown data

    Patients reported a total of 248 surgeries, an average of 2.3 procedures per patient.

    “Patients reported a total of 248 surgeries (average of 2.3 procedures per patient).”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The anonymous patient-reported outcome instrument used in the survey validly measures the impact of endometriosis on daily life and work.
    • Rests on an assumption: Patients' self-reported surgical diagnosis of endometriosis is accurate.

  • May combine two claims.

    Findingown data

    Hysterectomy was reported by 17% (n=18) of respondents, with an age range of 31-46 years.

    “Hysterectomy was reported by 17% (n=18) of respondents (age range: 31-46 y/o).”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The anonymous patient-reported outcome instrument used in the survey validly measures the impact of endometriosis on daily life and work.
    • Rests on an assumption: Patients' self-reported surgical diagnosis of endometriosis is accurate.

  • May combine two claims.

    Interpretationown data

    Menstrual pain, incapacitating pain, abdominal pain, and depression were identified as predictors of poor performance at work and home.

    “Therefore, menstrual pain, incapacitating pain, abdominal pain and depression were identified as predictors of poor performance at work and home.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The anonymous patient-reported outcome instrument used in the survey validly measures the impact of endometriosis on daily life and work.
    • Rests on an assumption: Patients' self-reported surgical diagnosis of endometriosis is accurate.

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    The diagnosis of endometriosis was supported by questions about the surgical procedure, surgeon, and rAFS endometriosis stage.

    “The diagnosis of endometriosis was supported by questions regarding the surgical procedure, surgeon, and rAFS endometriosis stage (25,26).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [25] Scarselli, 2005, Diagnosis and treatment of endometriosis, Minerva Ginecol

      Not checked in the free run.

    • cites [26] 1985, Revised American Fertility Society classification of endometriosis: 1985, Fertil Steril source

      Not checked in the free run.

    • Rests on an assumption: Patients' self-reported surgical diagnosis of endometriosis is accurate.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The yearly total cost of endometriosis has been estimated at €30 billion in Europe and $22 billion in the US, with direct costs increasing steadily.

    “The yearly total (direct plus indirect) cost of endometriosis has been estimated at €30 billion in Europe and $22 billion in the US, and direct costs have increased steadily (13,18-20).”
    Quote in the paperNot a substantial claim0 of 4 sources checked
    • cites [13] Gao, 2006, Economic burden of endometriosis, Fertil Steril source

      Not checked in the free run.

    • cites [18] Hummelshoj, 2006, Update on endometriosis, Women's Health source

      Not checked in the free run.

    • cites [19] Simoens, 2007, Endometriosis: cost estimates and methodological perspective, Hum Reprod Update source

      Not checked in the free run.

    • cites [20] Zhao, 1998, The cost of inpatient endometriosis treatment: an analysis based on the Healthcare Cost and Utilization Project Nationwide Inpatient Sample, Am J Manag Care

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The study protocol and survey were approved by the Ponce School of Medicine Institutional Review Board.

    “The study protocol and survey was approved by the Ponce School of Medicine (PSM) Institutional Review Board (IRB).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    Patients with endometriosis endure symptoms for years without being diagnosed, confirming a worrisome trend and worldwide public health problem.

    “This study thus confirms a worrisome trend and worldwide public health problem: patients with endometriosis endure symptoms for years without being diagnosed (8-12, 27-29).”
    Quote in the paperSubstantial claim0 of 8 sources checked
    • cites [8] Cox, 2003, Focus group study of endometriosis: struggle, loss and medical merry-go-round, Int J Nurs Pract source

      Not checked in the free run.

    • cites [9] Lemaire, 2004, More than just menstrual cramps: symptoms and uncertainty among women with endometriosis, J Obstet Gynecol Neonatal Nurs source

      Not checked in the free run.

    • cites [10] Cox, 2003, Learning to take charge: women's experiences of living with endometriosis, Complement Ther Nurs Midwifery source

      Not checked in the free run.

    • cites [11] Huntington, 2005, A life shaped by pain: women and endometriosis, J Clin Nurs source

      Not checked in the free run.

    • cites [12] Denny, 2004, Women's experience of endometriosis, J Adv Nurs source

      Not checked in the free run.

    • cites [27] Hadfield, 1996, Delay in the diagnosis of endometriosis: a survey of women from the USA and the UK, Hum Reprod source

      Not checked in the free run.

    • cites [28] Arruda, 2003, Time elapsed from onset of symptoms to diagnosis of endometriosis in a cohort study of Brazilian women, Hum Reprod source

      Not checked in the free run.

    • cites [29] Ballard, 2006, What's the delay? A qualitative study of women's experiences of reaching a diagnosis of endometriosis, Fertil Steril source

      Not checked in the free run.

    • Rests on an assumption: The anonymous patient-reported outcome instrument used in the survey validly measures the impact of endometriosis on daily life and work.
    • Rests on an assumption: Patients' self-reported surgical diagnosis of endometriosis is accurate.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    A total of 108 patients answered the survey, giving a response rate of 24%.

    “A total of 108 patients answered the survey, for a response rate of 24%.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    Subjects in the ERP registry come from all regions of Puerto Rico but do not necessarily accurately represent the female population of Puerto Rico.

    “Subjects in this patient registry come from all regions of the island; however, they do not necessarily accurately represent the female population of Puerto Rico.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    Prior patient-reported outcome studies concluded that endometriosis impairs health-related quality of life, particularly physical, psychological, and social function.

    “These studies concluded that endometriosis impairs health related quality of life (HRQoL), specifically in areas related to physical, psychological, and social function.”
    Quote in the paperSubstantial claim0 of 4 sources checked
    • cites [21] Gao, 2006, Health-related quality of life burden of women with endometriosis: a literature review, Curr Med Res Opin source

      Not checked in the free run.

    • cites [22] Jones, 2001, Development of an endometriosis quality-of-life instrument: The Endometriosis Health Profile–30, Obstet Gynecol

      Not checked in the free run.

    • cites [23] Jones, 2006, Measuring quality of life in women with endometriosis: tests of data quality, score reliability, response rate and scaling assumptions of the Endometriosis Health Profile Questionnaire, Hum Reprod source

      Not checked in the free run.

    • cites [24] Jones, 2004, Development of the Short Form Endometriosis Health Profile Questionnaire: the EHP-5, Qual Life Res source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    Only women reporting a diagnosis by laparoscopy or laparotomy were included in the analyses.

    “Only women reporting having been diagnosed by laparoscopy or laparotomy were included in the analyses.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Patients' self-reported surgical diagnosis of endometriosis is accurate.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Up to 80% of women with dysmenorrhea and up to 40% of infertile women have endometriosis.

    “It is estimated that up to 80% of women with dysmenorrhea and up to 40% of infertile women have endometriosis (2,3).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [2] Cramer, 2002, The epidemiology of endometriosis, Ann N Y Acad Sci source

      Not checked in the free run.

    • cites [3] Ozkan, 2008, Endometriosis and infertility: epidemiology and evidence-based treatments, Ann N Y Acad Sci source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    One patient was excluded because she did not report a surgical diagnosis.

    “One patient was excluded because she did not report a surgical diagnosis.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The patients surveyed represent 15% of the total number of patients in the ERP registry.

    “The patients surveyed represent 15% of the total number of patients in the ERP registry.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    There were no demographic differences (age, marital status, education) between respondents to the electronic and mailed questionnaires.

    “There were no differences in demographics (e.g., age, marital status, education) between respondents of the electronic versus the mailed questionnaires.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Endometriosis causes intractable pelvic pain, dysmenorrhea, dyspareunia, and infertility.

    “Endometriosis, the growth of endometrial tissue (glands and stroma) outside of the uterine cavity, causes intractable pelvic pain, dysmenorrhea, dyspareunia, and infertility (1).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [1] Corson, 1992

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductown data

    Logistic regression was used to determine which symptoms were more likely to affect daily life activities and work performance, controlling for age as a confounder.

    “Logistic regression analysis was conducted to determine which endometriosis-related and/or coexisting symptoms were more likely to affect daily life activities and work performance of patients. The following dependent variables were studied, controlling for age as confounding factor: household chores, work, social activities, sexual relationships, studies, childcare, sleeping, exercise, and appet”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Endometriosis is a more costly public health problem than migraine and Crohn's disease in women, due to high rates of hospital admissions, surgical procedures, and comorbid conditions.

    “The high rates of hospital admissions, surgical procedures, and incidence of comorbid conditions make endometriosis a more costly public health problem than commonly known medical conditions in women such as migraine and Crohn’s disease (13-17).”
    Quote in the paperNot a substantial claim0 of 5 sources checked
    • cites [13] Gao, 2006, Economic burden of endometriosis, Fertil Steril source

      Not checked in the free run.

    • cites [14] Winkel, 2001, Medical and surgical therapies for pain associated with endometriosis, J Womens Health Gend Based Med source

      Not checked in the free run.

    • cites [15] Heinrichs, 1998, Human issues and medical economics of endometriosis. Three- vs. six-month GnRH-agonist therapy, J Reprod Med

      Not checked in the free run.

    • cites [16] Mathias, 1996, Chronic pelvic pain: prevalence, health-related quality of life, and economic correlates, Obstet Gynecol source

      Not checked in the free run.

    • cites [17] Mirkin, 2007, Actuarial analysis of private payer administrative claims data for women with endometriosis, J Manag Care Pharm

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    For endometriosis, there is a paucity of data on work performance, although qualitative studies document patient-reported negative experiences at work.

    “For endometriosis, there is paucity of data in that regard, although qualitative studies document patient-reported negative experiences at work (5).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [5] Jones, 2004, The impact of endometriosis quality of life: a qualitative analysis, J Psychosom Obstet Gynecol source

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    The low response rate may be explained by cultural issues such as low awareness of the importance of research, which may explain poor participation rates in biomedical research previously reported in Hispanic minorities.

    “Finally, the low response rate observed may be explained by cultural issues such as the low awareness of the importance of research, which may explain the poor participation rates in biomedical research studies that have been previously reported in Hispanic minorities (44).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [44] Katz, 2008, Participation in biomedical research studies and cancer screenings: perceptions of risks to minorities compared with whites, Cancer Control source

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    This study supports previous findings that patients with endometriosis commonly endure painful symptoms and infertility, both of which could negatively affect quality of life and mental health at rates higher than healthy women or women with other gynecological disorders.

    “This study supports previous findings showing that patients with endometriosis commonly endure both painful symptoms and infertility, both of which could negatively affect the quality of life and mental health of the affected women at rates that are higher than those reported by healthy women or women with other gynecological disorders (6-12,35,36).”
    Quote in the paperNot a substantial claim0 of 9 sources checked
    • cites [6] Denny, 2006, Systematic reviews of qualitative evidence: what are the experiences of women with endometriosis?, J Obstet Gynaecol source

      Not checked in the free run.

    • cites [7] Marques, 2004, Quality of life in Brazilian women with endometriosis assessed through a medical outcome questionnaire, J Reprod Med

      Not checked in the free run.

    • cites [8] Cox, 2003, Focus group study of endometriosis: struggle, loss and medical merry-go-round, Int J Nurs Pract source

      Not checked in the free run.

    • cites [9] Lemaire, 2004, More than just menstrual cramps: symptoms and uncertainty among women with endometriosis, J Obstet Gynecol Neonatal Nurs source

      Not checked in the free run.

    • cites [10] Cox, 2003, Learning to take charge: women's experiences of living with endometriosis, Complement Ther Nurs Midwifery source

      Not checked in the free run.

    • cites [11] Huntington, 2005, A life shaped by pain: women and endometriosis, J Clin Nurs source

      Not checked in the free run.

    • cites [12] Denny, 2004, Women's experience of endometriosis, J Adv Nurs source

      Not checked in the free run.

    • cites [35] Peveler, 1996, Psychosocial factors and chronic pelvic pain: a comparison of women with endometriosis and with unexplained pain, J Psychosom Res source

      Not checked in the free run.

    • cites [36] Low, 1993, A psychological profile of endometriosis patients in comparison to patients with pelvic pain of other origins, J Psychosom Res source

      Not checked in the free run.

    • Rests on an assumption: The anonymous patient-reported outcome instrument used in the survey validly measures the impact of endometriosis on daily life and work.
    • Rests on an assumption: Patients' self-reported surgical diagnosis of endometriosis is accurate.

  • May combine two claims.

    Interpretationreasoning

    The findings may not be representative of all patients with endometriosis, but rather apply only to those with more severe disease.

    “Therefore, the findings of this study may not be representative of all patients with endometriosis, but rather apply only to those with more severe disease.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The anonymous patient-reported outcome instrument used in the survey validly measures the impact of endometriosis on daily life and work.
    • Rests on an assumption: Patients' self-reported surgical diagnosis of endometriosis is accurate.
32 of 32

  • The paper relies on this without support.

    The anonymous patient-reported outcome instrument used in the survey validly measures the impact of endometriosis on daily life and work.

    “An anonymous PRO instrument was distributed randomly via postal mail (n=200) or electronically to all the e-mail addresses in the ERP (n=361).”

  • The paper relies on this without support.

    Patients' self-reported surgical diagnosis of endometriosis is accurate.

    “Only women reporting having been diagnosed by laparoscopy or laparotomy were included in the analyses.”

  • The paper relies on this without support.

    In Puerto Rico, health insurance companies generally do not cover contraceptive drugs or infertility-related treatments and procedures.

    “In Puerto Rico, health insurance companies do not usually cover contraceptive drugs (even when prescribed as a treatment for endometriosis) or treatments/procedures related to infertility.”
3 of 3

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Presenteeism percentage exceeds its stated fraction

    Minor

    The stated count of 68 out of 101 patients is 67.3%, rather than 69%.

    Reported 69 · recomputed 67.326733

  • The same work-quality result has two percentages

    Minor

    The paper assigns both 85% and 84% to the identical count of 87 out of 103 patients.

2 of 2

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Authors
Fourquet, J., Gao, X., Zavala, D., Orengo, J. C., Abac, S., Ruiz, A., Laboy, J., & Flores, I.
Affiliations
  • Ponce Health Sciences University (PR)
  • Pharmerit (United States) (US)
Corresponding author
Flores, Idhaliz
ORCID
Venue
Fertility and Sterility
Publisher
Elsevier BV
Published
2010-05
Volume
93
Issue
7
Pages
2424-2428
ISSN
0015-0282 (ISSN-L)
DOI
10.1016/j.fertnstert.2009.09.017
PMC
PMC2860000
OpenAlex
W2166839144
Semantic Scholar
f2526427b44d06fe71d225ff8a20012c18498838
Cited by
252
References
57
Citations by year
2026: 14 · 2025: 18 · 2024: 18 · 2023: 18 · 2022: 25 · 2021: 23 · 2020: 25 · 2019: 17 · 2018: 18 · 2017: 14 · 2016: 9 · 2015: 17 · 2014: 6 · 2013: 12 · 2012: 8
FWCI
6.67
Type
journal article
Language
en
Open access
Licence
Locations
  • Fertility and Sterility (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (5g12rr003050-25, 5s06gm008239-23)
  • National Institute of General Medical Sciences (S06 GM-08239, S06-GM 008239)
  • National Center for Research Resources (G12 RR-003050)
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD050559)
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ectopic Pregnancy Diagnosis and Management
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Menstrual Health and Disorders
Keywords
endometriosis, patient-reported outcomes, disease burden, quality of life, work disability, physical limitations, everyday life, women's health
MeSH terms
Activities of Daily Living, Adult, Endometriosis, Female, Health, Humans, Infertility, Female, Middle Aged, Quality of Life, Surveys and Questionnaires, Self Concept, Task Performance and Analysis, Uterine Diseases, Work, Case-Control Studies, Women's Health, Cost of Illness, Pelvic Pain, Health Records, Personal

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-09-30.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-09-30.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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