The DOI matches its Crossref record; 54 of the 56 references it cites were found in a registry or an index; 27 of the 67 sources its claims cite were checked for support.
Endometriosis and Risk of Coronary Heart Disease
Open accessAbstract
Background—: Endometriosis is a prevalent gynecologic disease associated with systemic chronic inflammation, heightened oxidative stress, and atherogenic lipid profile that may increase women’s risk for coronary heart disease (CHD). Methods and Results—: We examined the prospective association between laparoscopically confirmed endometriosis and subsequent CHD among 116 430 women in the Nurses’ Health Study II (1989–2009). Participants with a history of heart disease and stroke were excluded. When compared with women without endometriosis, women with laparoscopically confirmed endometriosis had a higher risk of myocardial infarction (relative risk, 1.52; 95% confidence interval, 1.17–1.98), angiographically confirmed angina (1.91; 1.59–2.29), coronary artery bypass graft surgery/coronary angioplasty procedure/stent (1.35; 1.08–1.69), or any of these CHD end points combined (1.62; 1.39–1.89), independent of potential demographic, anthropometric, family history, reproductive, and lifestyle confounders. Relative risk for the combined CHD end point was highest among women aged ≤40 years (3.08; 2.02–4.70) and decreased as age increased (40< age ≤50 years, 1.65; 1.35–2.02; 50< age ≤55 years, 1.44; 1.07–1.94; and age >55 years, 0.98; 0.56–1.72; P value, test for heterogeneity=0.001). Having had a hysterectomy/oophorectomy was associated with higher risk of combined CHD compared with not having had a hysterectomy/oophorectomy (1.51; 1.34–1.71). A percentage of 42 of the association between endometriosis and CHD could be explained by greater frequency of hysterectomy/oophorectomy and earlier age at surgery after endometriosis diagnosis. Conclusions—: In this large, prospective cohort, laparoscopically confirmed endometriosis was associated with increased risk of CHD. The association was strongest among young women. Hysterectomy/oophorectomy was associated with higher risk of CHD and could partially explain the association between endometriosis and CHD.
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Claims the paper makes
23 Own method · 17 Own result · 9 Partly supported · 9 Own interpretation · 7 No full text of the sources · 3 Supported · 2 Supported so far · 2 Sources not found · 2 Not checked yet · 2 No basis given · accuracy not yet measured
Every source the paper cites for this claim was checked and supports it.
In the paper
“Chronic systemic inflammation contributes to vascular insult and atheromatous plaque progression.(16)”
§ Endometriosis and Risk of Coronary Heart Disease > Introduction
What the sources say
- Supportedcites [16] source
The Abstract says systemic inflammation is an important contributor to atherogenesis and links increased inflammation to accelerated atherogenesis. The Increased Cardiovascular Risk and C-Reactive Protein sections describe vasculopathic effects and mechanisms of vascular inflammation. Page numbers are not supplied in our copy. (LLM, conf=0.92)
plaindirect- Asserted: passes — The authors put it forward as true.
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- Supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Additionally, endometriosis and CHD may share common genetic susceptibilities.”
§ Endometriosis and Risk of Coronary Heart Disease > Discussion
What the sources say
- Supportedcites [38] source
In Results, under “Current understanding of biological mechanisms of the genetic loci” (page unavailable), the paper identifies coronary heart disease-associated variants in linkage disequilibrium with endometriosis-associated variants at the CDKN2B-AS1 locus. This supports the cautious claim that the two conditions may share genetic susceptibilities. (LLM, conf=0.91)
- Not checked — no full text of the sourcecites [39] source
- Could not verifycites [40] sourceExperimental — accuracy not yet measured
The Discussion identifies genetic loci associated with coronary artery disease and raises the possibility of a shared mechanism with type 2 diabetes, not endometriosis. A search for “endometriosis” in our full-text copy found no passage addressing whether it shares genetic susceptibility with coronary heart disease; no page numbers were available. (LLM, conf=0.74)
- Not checked — no full text of the sourcecites [41] source
- Could not verifycites [42] sourceExperimental — accuracy not yet measured
The Abstract reports a chromosome 9 allele associated with CHD risk, but it does not address endometriosis or a genetic susceptibility shared by the two conditions. A search for “endometriosis” in our copy found no passage discussing it. (LLM, conf=0.76)
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
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- Supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“and has also been robustly associated with CHD outcomes.(40-42)”
§ Endometriosis and Risk of Coronary Heart Disease > Discussion
What the sources say
- Supportedcites [40] source
The Results (Primary Analysis; page not specified) report a strong association between the chromosome 9p21.3 locus and coronary artery disease, with a combined P value of 2.91×10−19. The Discussion (page not specified) also reports an association with myocardial infarction and describes the locus as highly replicated. (LLM, conf=0.92)
- Not checked — no full text of the sourcecites [41] source
- Supportedcites [42] source
The paper’s Abstract (page unavailable) reports that a 58 kb interval on chromosome 9 was consistently associated with CHD in six independent samples. It locates the risk interval near CDKN2B, although it does not use the later CDKN2BAS1/ANRIL name. (LLM, conf=0.90)
boostedcorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“In addition, the treatments of endometriosis, such as hysterectomy or oophorectomy (20-24) and analgesics (25) may confer increased risk of CHD to women with endometriosis.”
§ Endometriosis and Risk of Coronary Heart Disease > Introduction
What the sources say
- Partly supportedcites [20] sourceExperimental — accuracy not yet measured
The Results (Overall cardiovascular disease mortality) associate bilateral oophorectomy before age 45 with increased cardiovascular mortality, which supports the broader concern about surgical risk. But the Results (Specific cardiovascular causes of death) report no increased coronary heart disease mortality when analyzed separately; the paper does not establish this risk specifically for women with endometriosis. The analgesics portion is attached to a different citation. (LLM, conf=0.88)
- Not checked — no full text of the sourcecites [21] source
- Partly supportedcites [22] sourceExperimental — accuracy not yet measured
The Results (page not available) associate bilateral oophorectomy at hysterectomy with higher CHD mortality, and the Introduction reports an earlier finding of higher incident CHD. The paper does not establish this association specifically in women with endometriosis or for hysterectomy without oophorectomy. The sentence cites a different source for analgesics, so that part is not assessed here. (LLM, conf=0.86)
- Partly supportedcites [23] sourceExperimental — accuracy not yet measured
The Results (p. 3) associate hysterectomy and oophorectomy with increased coronary heart disease risk in women under 50, supporting the surgical-treatment portion of the claim. The paper does not establish that risk specifically in women with endometriosis, and reports a different pattern in women aged 50 or older. Analgesics are attached to a separate citation in the citing sentence. (LLM, conf=0.86)
- Partly supportedcites [24] sourceExperimental — accuracy not yet measured
The Results (page unavailable) report higher unadjusted rates of cardiovascular disease among women with a hysterectomy, with or without oophorectomy. But the study did not examine women with endometriosis as a group, and its hysterectomy associations with coronary heart disease outcomes were not statistically significant. This citation supports a possible cardiovascular association, not the specific claim of increased CHD risk in women with endometriosis; the separate analgesics citation is outside this verdict. (LLM, conf=0.84)
- Partly supportedcites [25] sourceExperimental — accuracy not yet measured
The Discussion (page unavailable) reports that NSAIDs increase the risk of non-fatal myocardial infarction, supporting a possible coronary risk from this class of analgesics. It does not establish that analgesics generally increase CHD risk in women with endometriosis. The hysterectomy and oophorectomy portion is attributed to other citations, not this paper. (LLM, conf=0.88)
hedgedconditional- Asserted: passes — The authors put it forward as true.
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- Partly supported
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In the paper
“Various inflammatory factors, e.g. interleukin-1, interleukin-6, tumor necrosis factor-α, have been observed to be elevated both in peritoneal fluid (4-6) and the peripheral blood (4, 5, 7) of women with endometriosis compared to controls.”
§ Endometriosis and Risk of Coronary Heart Disease > Introduction
What the sources say
- Not checked — no full text of the sourcecites [4] source
- Not checked — no full text of the sourcecites [5] source
- Partly supportedcites [6] sourceExperimental — accuracy not yet measured
The Results (page not available in our copy) report significantly higher interleukin-1β in the peritoneal fluid of women with endometriosis than controls. The paper does not establish that interleukin-6 or tumor necrosis factor-α is elevated there, or that these cytokines are elevated in peripheral blood; its peripheral-blood discussion instead concerns reduced soluble IL-1 receptor type II. (LLM, conf=0.88)
- Not checked — no full text of the sourcecites [7] source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Multiple independent loci in the CDKN2BAS1 (also known as ANRIL) region on chromosome 9p21 have been robustly associated with endometriosis in genome-wide association studies in Japanese and European ancestry populations,(38, 39)”
§ Endometriosis and Risk of Coronary Heart Disease > Discussion
What the sources say
- Partly supportedcites [38] sourceExperimental — accuracy not yet measured
The Results section reports an association for rs10965235 in a Japanese GWAS and a genome-wide significant association for rs1537377 across Japanese and European-ancestry datasets. It describes the evidence that these are independent risk variants as suggestive, not robustly established. It also notes that rs10965235 is monomorphic in European-ancestry individuals, so the claim overstates the evidence for multiple independent loci across both populations. (LLM, conf=0.87)
- Not checked — no full text of the sourcecites [39] source
boostedcorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“We observed higher risk of CHD among women who had a hysterectomy/oophorectomy compared to women who did not have a hysterectomy/oophorectomy. These associations were not altered when potential confounding factors, e.g., age, parity, BMI, race/ethnicity (45-47), were adjusted for in the multivariable analyses.”
§ Endometriosis and Risk of Coronary Heart Disease > Discussion
What the sources say
- Not checked — no full text of the sourcecites [45] source
- Not checked — no full text of the sourcecites [46] source
- Partly supportedcites [47] sourceExperimental — accuracy not yet measured
Split into 2 atoms — 1 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 1 unverifiable. Expand the claim to see per-atom verdicts.
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“having had a hysterectomy/oophorectomy was associated with higher risk of combined CHD compared to not having had a hysterectomy/oophorectomy (1.51, 1.34 to 1.71).”
§ Endometriosis and Risk of Coronary Heart Disease > Results > Relationship between endometriosis, hysterectomy/oophorectomy and combined CHD
plaincorrelational- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The incidence rate difference between women with endometriosis and women without endometriosis increased slowly as age increased until around age 50.”
§ Endometriosis and Risk of Coronary Heart Disease > Results > Age as a modifier on the association between endometriosis and CHD
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We observed that 42% of the association between endometriosis and CHD was statistically significantly accounted for by greater frequency of hysterectomy/oophorectomy and earlier age at these surgeries among women with endometriosis (Table 3).”
§ Endometriosis and Risk of Coronary Heart Disease > Results > Relationship between endometriosis, hysterectomy/oophorectomy and combined CHD
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We observed a statistically significant interaction between endometriosis and age for the combined CHD endpoint.”
§ Endometriosis and Risk of Coronary Heart Disease > Results > Age as a modifier on the association between endometriosis and CHD
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“During the 20 years follow up among 1,971,574 person-years, there were 1,438 incident combined CHD cases.”
§ Endometriosis and Risk of Coronary Heart Disease > Results > Association between endometriosis and CHD
plainn = 1,438- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Having had a hysterectomy/oophorectomy was associated with higher age-standardized absolute incidence rates of CHD compared to those who had not: 139 vs. 60 per 100,000 person years”
§ Endometriosis and Risk of Coronary Heart Disease > Results > Relationship between endometriosis, hysterectomy/oophorectomy and combined CHD
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We observed that approximately 40% of the observed significant association between endometriosis and CHD may be statistically accounted for by hysterectomy/oophorectomy and age at surgery.”
§ Endometriosis and Risk of Coronary Heart Disease > Discussion
hedgedconditional- Asserted: passes — The authors put it forward as true.
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The remaining ~50% of the significant association between endometriosis and CHD was not explained by endometriosis treatments.”
§ Endometriosis and Risk of Coronary Heart Disease > Discussion
plaincorrelational- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In this large prospective cohort, laparoscopically-confirmed endometriosis was associated with higher risk of CHD.”
§ Endometriosis and Risk of Coronary Heart Disease > Conclusions
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The association was stronger among young women.”
§ Endometriosis and Risk of Coronary Heart Disease > Conclusions
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Adjustment for potential risk factors and indication for hysterectomy/oophorectomy did not attenuate this association.”
§ Endometriosis and Risk of Coronary Heart Disease > Results > Relationship between endometriosis, hysterectomy/oophorectomy and combined CHD
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Among women without laparoscopic confirmation, evidence of clinical diagnosis or symptoms was found in only 54% (n=14/26) of the records.”
§ Endometriosis and Risk of Coronary Heart Disease > Methods > Assessment of endometriosis
plainn = 14- Asserted: passes — The authors put it forward as true.
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In the paper
“The significant association between endometriosis and combined CHD remained after adjustment for each treatment factor.”
§ Endometriosis and Risk of Coronary Heart Disease > Results > Association between endometriosis and CHD
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Systemic chronic inflammation, heightened oxidative stress and atherogenic lipid profile associated with endometriosis and the synergistic effect of the three may underpin the biologic mechanism for the association between endometriosis and CHD.”
§ Endometriosis and Risk of Coronary Heart Disease > Discussion
hedgedconditional- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Thus, self-reported physician-diagnosed endometriosis without laparoscopic confirmation may be substantially misclassified”
§ Endometriosis and Risk of Coronary Heart Disease > Methods > Assessment of endometriosis
hedged- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“the surgical report validation for self-reported laparoscopically-confirmed endometriosis cases within this cohort is 96% (n=101/105).”
§ Endometriosis and Risk of Coronary Heart Disease > Methods > Assessment of endometriosis
plainn = 101- Asserted: passes — The authors put it forward as true.
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In the paper
“Results were unchanged when using marginal structural models.”
§ Endometriosis and Risk of Coronary Heart Disease > Results > Association between endometriosis and CHD
plain- Asserted: passes — The authors put it forward as true.
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A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Inflammation, oxidative stress and an atherogenic lipid profile play key roles in the pathogenesis of atherosclerotic CHD.(13-15)”
§ Endometriosis and Risk of Coronary Heart Disease > Introduction
What the sources say
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Lastly, the results were robust across multiple definitions of CHD.”
§ Endometriosis and Risk of Coronary Heart Disease > Discussion > Strengths and limitations of the study
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“We also did not have information on the extent of excision of endometriosis lesions during laparoscopy to evaluate whether the excision could alter the elevated CHD risk associated with endometriosis, although no current cohort of sufficient size has these data.”
§ Endometriosis and Risk of Coronary Heart Disease > Discussion > Strengths and limitations of the study
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Minimal confounding was seen.”
§ Endometriosis and Risk of Coronary Heart Disease > Discussion > Strengths and limitations of the study
plain- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“suggesting women with endometriosis may represent a high risk group for CHD -- particularly at a young age”
§ Endometriosis and Risk of Coronary Heart Disease > Conclusions
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Adjustment did not change the association between hysterectomy/oophorectomy and CHD.”
§ Endometriosis and Risk of Coronary Heart Disease > Discussion
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“we additionally adjusted for husband's education level and household income, again with no evidence of confounding.”
§ Endometriosis and Risk of Coronary Heart Disease > Discussion
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The wealth of time-varying data allowed for detailed adjustment for known and suspected potential confounders and risk factors for CHD.”
§ Endometriosis and Risk of Coronary Heart Disease > Discussion > Strengths and limitations of the study
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“We did not have information on other hormonal treatments for endometriosis, such as danazol (a synthetic androgen) and Leuprolide (lupron, gonadotropin-releasing hormone analog) to assess to what extent the association between endometriosis and CHD could have been explained by those treatments.”
§ Endometriosis and Risk of Coronary Heart Disease > Discussion > Strengths and limitations of the study
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“it is unlikely that the underlying biologic relation observed between endometriosis and CHD, if true, would differ between these women and women in the general population.”
§ Endometriosis and Risk of Coronary Heart Disease > Discussion > Strengths and limitations of the study
hedged- Asserted: passes — The authors put it forward as true.
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- Based: unclear — It is unclear why the paper says it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“sensitivity analyses predating diagnosis time of endometriosis for 2, 4, 6 or 8 years didn't change our results.”
§ Endometriosis and Risk of Coronary Heart Disease > Discussion > Strengths and limitations of the study
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, the small attenuation of relative risk from the crude models to the comprehensive multivariable models suggests that strong confounding is unlikely.”
§ Endometriosis and Risk of Coronary Heart Disease > Discussion
hedged- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“However, in sensitivity analyses expanded definition of endometriosis cases by attributing person time from endometriosis without laparoscopic confirmation to the exposed group did not alter the results.”
§ Endometriosis and Risk of Coronary Heart Disease > Discussion > Strengths and limitations of the study
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- It may state two separate claims as one. 27
- Probably not a substantial claim. 17
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Endometriosis has been linked to systemic chronic inflammation, heightened oxidative stress and an atherogenic lipid profile.”
§ Endometriosis and Risk of Coronary Heart Disease > Introduction
What the sources say
- Not checked — no full text of the sourcecites [4] source
- Not checked — no full text of the sourcecites [5] source
- Partly supportedcites [6] sourceExperimental — accuracy not yet measured
The Discussion states that endometriosis is associated with a chronic immunoinflammatory reaction frequently observed at both local and systemic levels. The paper does not address heightened oxidative stress or an atherogenic lipid profile; searches for oxidative stress and lipid-profile terms returned no supporting passages. No page number was available in our copy. (LLM, conf=0.90)
- Not checked — no full text of the sourcecites [8] source
- Not checked — no full text of the sourcecites [9] source
- Not checked — no full text of the sourcecites [10] source
- Not matchedcites [11]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
Every source the paper cites for this claim was checked and supports it.
In the paper
“while a study in 10 countries observed an average delay of 6.7 years.(29)”
§ Endometriosis and Risk of Coronary Heart Disease > Methods > Assessment of endometriosis
What the sources say
- Supportedcites [29] source
The Results (Endometriosis: Care-Seeking Experience) report a diagnostic delay of 6.7 years in women with endometriosis. The Abstract (Setting) identifies 16 clinical centers in ten countries. (LLM, conf=0.94)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Chr9p21 encodes the long non-coding RNA(ncRNA) ANRIL, which has been demonstrated to regulate cell proliferation, adhesion and apoptosis,(43, 44) - central mechanisms of atherogenesis (13, 43) and endometriosis. (2, 3)”
§ Endometriosis and Risk of Coronary Heart Disease > Discussion
What the sources say
- Supportedcites [43] source
The Introduction identifies ANRIL as a long non-coding RNA encoded at chromosome 9p21. The Results and Discussion report that ANRIL affects proliferation, adhesion, and apoptosis and describe these as mechanisms of atherogenesis. In the citing sentence, endometriosis has separate citations (2, 3), so it is not attributed to this source. (LLM, conf=0.93)
- Partly supportedcites [44] sourceExperimental — accuracy not yet measured
The Introduction identifies ANRIL as a non-coding RNA gene at 9p21, and the Results and Discussion link ANRIL expression to cell-cycle regulators in vascular smooth muscle cells. The paper also associates 9p21 variation with smooth muscle cell proliferation in atherosclerosis, but it does not demonstrate that ANRIL regulates adhesion or apoptosis. The citing sentence attributes its endometriosis point to other references, not this source. (LLM, conf=0.86)
- Not checked — no full text of the sourcecites [13] source
- Not checked — no full text of the sourcecites [2] source
- Not checked — no full text of the sourcecites [3] source
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“The surgically-induced menopause prior to a natural menopause may increase risk of CHD among women, and this elevated risk may be most evident at a younger age (i.e., before all women reach natural menopause). (20-24)”
§ Endometriosis and Risk of Coronary Heart Disease > Introduction
What the sources say
- Partly supportedcites [20] sourceExperimental — accuracy not yet measured
The Results (no page supplied) associate bilateral oophorectomy before age 45 with increased cardiovascular mortality, supporting the concern about surgery before natural menopause. But the study measured deaths rather than CHD incidence, found no increase in CHD mortality considered separately, and examined mortality many years after surgery; it does not establish that the elevated risk is most evident while women are younger. (LLM, conf=0.87)
- Not checked — no full text of the sourcecites [21] source
- Supportedcites [22] source
The Results report higher CHD mortality after bilateral oophorectomy than after ovarian conservation, including a significant increase among women who had hysterectomy before age 50. They also report higher CHD mortality in the under-50 subgroup who had never used estrogen therapy. The paper cautions that mortality results were not statistically different when stratified by age, so the claim’s tentative 'may be most evident' is appropriate. (LLM, conf=0.88)
- Supportedcites [23] source
The Results (p. 3) report increased coronary heart disease incidence associated with hysterectomy and oophorectomy in women under 50, but not an increased risk in the older group. The Discussion (p. 5) says the adverse cardiovascular associations were notable only in younger women and suggests surgical menopause may explain them. This supports the citing sentence’s hedged claim. (LLM, conf=0.92)
- Partly supportedcites [24] sourceExperimental — accuracy not yet measured
The paper says that surgery well before natural menopause may affect cardiovascular function, and its Results report higher overall cardiovascular disease rates among women with a history of hysterectomy. It does not show that coronary heart disease risk is greatest at younger ages: the cohort was postmenopausal and aged 50–79, and the Results report no significant association for the specified coronary outcomes (MI or coronary death). Page numbers are unavailable in our copy. (LLM, conf=0.84)
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Loss of ovarian function and subsequent deficiency of endogenous estrogens may be the biologic mechanism for association between bilateral oophorectomy and cardiovascular diseases, while simple hysterectomy can interfere with ovarian blood flow and may result in premature ovarian failure.(23)”
§ Endometriosis and Risk of Coronary Heart Disease > Discussion
What the sources say
- Supportedcites [23] source
Split into 2 atoms — 2 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“A nationwide study from Sweden showed that hysterectomy without oophorectomy was associated with an increased risk of cardiovascular diseases in women age<50 but not in women age ≥50.(23, 24)”
§ Endometriosis and Risk of Coronary Heart Disease > Discussion
What the sources say
- Supportedcites [23] source
The Methods and results (p. 1) describe a nationwide Swedish cohort and report increased CVD risk after hysterectomy without oophorectomy among women under 50 at study entry. They report no significant association between hysterectomy and incident CVD among women aged 50 or above at study entry. (LLM, conf=0.94)
- Partly supportedcites [24] sourceExperimental — accuracy not yet measured
The Discussion (p. 1468) reports that hysterectomy without oophorectomy was associated with higher CVD risk in unadjusted analysis, but that the association was mostly no longer significant after adjustment for risk factors. This paper analyzes a US Women's Health Initiative cohort, not a nationwide Swedish study, and it does not report the claimed difference between women under and over 50. (LLM, conf=0.87)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“bilateral oophorectomy at ages younger than 50 has been associated with an increased incidence and mortality of cardiovascular diseases, although results have been inconclusive for bilateral oophorectomy at ages older than 50.(20-22)”
§ Endometriosis and Risk of Coronary Heart Disease > Discussion
What the sources say
- Partly supportedcites [20] sourceExperimental — accuracy not yet measured
The Results report increased cardiovascular mortality after bilateral oophorectomy before age 45, particularly among women who did not continue estrogen treatment through age 45. The study measured mortality, not cardiovascular disease incidence; its significant finding is for under 45 rather than all women under 50, and the cited passages do not characterize results after age 50 as inconclusive. (LLM, conf=0.88)
- Not checked — no full text of the sourcecites [21] source
- Partly supportedcites [22] sourceExperimental — accuracy not yet measured
The Results report increased coronary heart disease mortality among women who had oophorectomy before age 50. They do not establish increased cardiovascular disease incidence, and the paper focuses on mortality after hysterectomy rather than incidence. For older women, the Results say CVD mortality estimates remained elevated at age 60 and above, although mortality outcomes did not differ statistically when stratified by age; this supports uncertainty about an age-specific effect, not a clear older-than-50 contrast. (LLM, conf=0.87)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“this validation study determined that the average diagnostic delay (from symptom onset to surgical diagnosis) was 4 years in this cohort”
§ Endometriosis and Risk of Coronary Heart Disease > Methods > Assessment of endometriosis
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“While 31% of the association could be statistically accounted for by greater frequency and longer duration of postmenopausal hormone use, this was primarily driven by greater frequency and earlier age at hysterectomy/oophorectomy.”
§ Endometriosis and Risk of Coronary Heart Disease > Results > Relationship between endometriosis, hysterectomy/oophorectomy and combined CHD
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In age and calendar year adjusted analyses, the relative risks - comparing women with laparoscopically-confirmed endometriosis (n = 11,903 by end of follow-up) to women without - were 1.63 (95% confidence interval, 1.27 to 2.11) for myocardial infarction, 2.07 (1.73 to 2.47) for angiographically-confirmed angina, 1.49 (1.19 to 1.86) for coronary artery bypass graft surgery/angioplasty/stent and 1.”
§ Endometriosis and Risk of Coronary Heart Disease > Results > Association between endometriosis and CHD
plaincorrelationaln = 11,903- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The relative risk was highest among women age≤40 (3.08, 2.02 to 4.70) and decreased as age increased (40<age ≤50, 1.65, 1.35 to 2.02; 50<age ≤55, 1.44, 1.07 to 1.94; age >55, 0.98, 0.56 to 1.72; p-value, test for heterogeneity=0.001).”
§ Endometriosis and Risk of Coronary Heart Disease > Results > Age as a modifier on the association between endometriosis and CHD
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Results remained statistically significant after adjustment for potential confounders (myocardial infarction, 1.52, 1.17 to 1.98; angina, 1.91, 1.59 to 2.29; coronary artery bypass graft surgery/angioplasty/stent, 1.35, 1.08 to 1.69; combined CHD, 1.62, 1.39 to 1.89) (Table 2).”
§ Endometriosis and Risk of Coronary Heart Disease > Results > Association between endometriosis and CHD
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“thus women with endometriosis are much more likely than the general population to undergo hysterectomy or oophorectomy and also receive the surgery at a much younger age.”
- Also stated in: § Association between endometriosis and CHD · plain
“Women with endometriosis were also much more likely to have had a hysterectomy and/or oophorectomy and to have had these at an earlier age, be surgically postmenopausal, and use postmenopausal hormones and analgesics.”
§ Endometriosis and Risk of Coronary Heart Disease > Introduction
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Also stated in: § Association between endometriosis and CHD · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Figure 1 demonstrates that women with endometriosis had a higher absolute incidence rate of combined CHD compared to women without endometriosis across ages before late the 50s; the two absolute incidence rates crossed at ages in the late 50s - after which the two groups had similar incidence rates (Figure 1).”
§ Endometriosis and Risk of Coronary Heart Disease > Results > Age as a modifier on the association between endometriosis and CHD
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Women with endometriosis were also much more likely to have had a hysterectomy and/or oophorectomy and to have had these at an earlier age, be surgically postmenopausal, and use postmenopausal hormones and analgesics.”
§ Endometriosis and Risk of Coronary Heart Disease > Results > Association between endometriosis and CHD
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We observed that the increased risk of CHD in women with endometriosis was greatest among younger women, and there was no increased risk from endometriosis after women reached the late 50s.”
§ Endometriosis and Risk of Coronary Heart Disease > Discussion
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Elevated concentration of low-density lipoprotein enhances its retention under the arterial wall(17); retention and oxidation of low-density lipoprotein are fundamental events in atherogenesis.(18)”
§ Endometriosis and Risk of Coronary Heart Disease > Introduction
What the sources say
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Moreover, women with endometriosis have been suggested to have higher serum levels of low-density lipoprotien (10-12) but lower high-density lipoprotein. (10, 11)”
§ Endometriosis and Risk of Coronary Heart Disease > Introduction
What the sources say
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Increasing evidence supports that reactive oxygen species contributes to the process of atherogenesis, as important mediators of signaling pathways that lead to vascular inflammation.(15)”
§ Endometriosis and Risk of Coronary Heart Disease > Introduction
What the sources say
- Not checked — no full text of the sourcecites [15] source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The response rate across the 20 years since enrollment has been consistently over 90% for each questionnaire cycle and did not vary by endometriosis status.”
§ Endometriosis and Risk of Coronary Heart Disease > Results > Association between endometriosis and CHD
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Non-fatal myocardial infarctions were classed as “confirmed” if they met the criteria of the World Health Organization: symptoms and either diagnostic electrocardiographic changes or raised cardiac enzymes,(30)”
§ Endometriosis and Risk of Coronary Heart Disease > Methods > Assessment of CHD
What the sources say
- Not matchedcites [30]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
- Not matched
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Results were also unchanged when multiple imputation was applied instead of the missing indicator method to address missing data in any covariate.”
§ Endometriosis and Risk of Coronary Heart Disease > Results > Association between endometriosis and CHD
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Fatal myocardial infarction was confirmed by hospital records, the National Death Index, or autopsy.”
§ Endometriosis and Risk of Coronary Heart Disease > Methods > Assessment of CHD
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Clinicians blinded to the questionnaire information reviewed medical records from self-reported non-fatal myocardial infarction events.”
§ Endometriosis and Risk of Coronary Heart Disease > Methods > Assessment of CHD
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Therefore, we also applied marginal structural models with inverse probability weighting to adjust for potential time-dependent confounding.”
§ Endometriosis and Risk of Coronary Heart Disease > Methods > Statistical Analysis
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“Missing covariate values were handled by the missing indicator method.(31) Multiple imputation to handle the missing data also was performed as a sensitivity analysis.”
§ Endometriosis and Risk of Coronary Heart Disease > Methods > Statistical Analysis
What the sources say
- Not matchedcites [31]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Not matched
In the paper
“we stratified the association between endometriosis and combined CHD by age groups (<40, 40-50, 50-55, ≥55), and tested the statistical significance of the interaction between age and endometriosis with likelihood ratio tests.(33)”
§ Endometriosis and Risk of Coronary Heart Disease > Methods > Statistical Analysis
What the sources say
- Not checked — no full text of the sourcecites [33] source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Studies also have suggested an increase of markers of oxidative stress but a decrease of antioxidants in the peritoneal fluid (8, 9) and peripheral blood (10, 11) among women with endometriosis.”
§ Endometriosis and Risk of Coronary Heart Disease > Introduction
What the sources say
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Therefore, the presence of endometriosis may promote coronary artery atherosclerosis formation and progression, increasing the risk of CHD.”
§ Endometriosis and Risk of Coronary Heart Disease > Introduction
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In contrast, high-density lipoprotein is antiatherogenic, removing cholesterol from cells in the arterial intima.(19)”
§ Endometriosis and Risk of Coronary Heart Disease > Introduction
What the sources say
- Not checked — no full text of the sourcecites [19] source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“to further account for risk factors of hysterectomy, we added adjustment for household income, husband's education and geographic region of residence. We also further adjusted for potential indication for hysterectomy including infertility history and analgesics use (in addition to oral contraceptive) as indicators of endometriosis clinical severity.”
§ Endometriosis and Risk of Coronary Heart Disease > Methods > Statistical Analysis
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The longitudinal study design, large sample size and 20 years of follow-up allowed us to document the prospective association between surgically diagnosed endometriosis and subsequent risk of CHD.”
§ Endometriosis and Risk of Coronary Heart Disease > Discussion > Strengths and limitations of the study
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The mediation proportion estimated from this model can be interpreted as the mediation proportion to be observed in this study population or any other study population with a similar proportion of treatment and a similar age distribution.”
§ Endometriosis and Risk of Coronary Heart Disease > Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“as Zondervan (51) et al. quantified, the likely prevalence of undiagnosed endometriosis should not exceed 2% of the unexposed population, and therefore too low to impact on the results, particularly in our large study population among whom undiagnosed endometriosis become diluted among tens of thousands of those with no endometriosis.”
§ Endometriosis and Risk of Coronary Heart Disease > Discussion > Strengths and limitations of the study
What the sources say
- Not checked — no full text of the sourcecites [51] source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“our unexposed group (i.e. never clinically or surgically diagnosed with endometriosis) may include asymptomatic endometriosis or symptomatic without confirmatory diagnosis. If so, our results would be biased toward the null.”
§ Endometriosis and Risk of Coronary Heart Disease > Discussion > Strengths and limitations of the study
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Moreover, because the results of multivariable Cox models and marginal structural models were almost identical, the potential bias that may remain within multivariable Cox models for adjustment of time-varying confounding (32) was negligible.”
§ Endometriosis and Risk of Coronary Heart Disease > Discussion
What the sources say
- Not checked — no full text of the sourcecites [32] source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“It is possible that the observed increased risk associated with surgical menopause from hysterectomy/oophorectomy among women with endometriosis started to diminish with age partially because nearly every woman had reached menopause by age 55.”
§ Endometriosis and Risk of Coronary Heart Disease > Discussion
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Finally, the timing of exposure was defined by time of surgical diagnosis, not disease onset.”
§ Endometriosis and Risk of Coronary Heart Disease > Discussion > Strengths and limitations of the study
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Hysterectomy/oophorectomy was associated with higher risk of CHD and could explain a portion of the association between endometriosis and CHD.”
§ Endometriosis and Risk of Coronary Heart Disease > Conclusions
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper relies on this without support.
This is the first prospective cohort study investigating the association between endometriosis and coronary heart disease.
“To our knowledge, this is the first prospective cohort study investigating the association between endometriosis and CHD.”
The paper relies on this without support.
Self-reported physician-diagnosed angina confirmed by angiography, coronary artery bypass graft surgery/angioplasty/stent, and time of diagnosis are accurate enough for the study's coronary heart disease outcome classification.
“Physician-diagnosed angina confirmed by angiography, coronary artery bypass graft surgery/angioplasty/stent and time of diagnosis were self-reported.”
The paper relies on this without support.
The missing data mechanism is such that the missing indicator method and multiple imputation yield valid estimates.
“Missing covariate values were handled by the missing indicator method.(31) Multiple imputation to handle the missing data also was performed as a sensitivity analysis.”
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?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“The NHS II studies were limited to investigating the association between endometriosis, IHD risk and hypertension risk. 30,31”
From Risk of cardiovascular outcomes among women with endometriosis in the United Kingdom: a retrospective matched cohort study (2021) · cites this paper as [30]
Experimental — accuracy not yet measuredIn the citing paper
“Certain reproductive factors, including endometriosis, pelvic inflammatory disease, first trimester bleeding without miscarriage, and anaemia in pregnancy, have been linked to an increased risk of future cardiovascular disease events”
From Association between the reproductive health of young women and cardiovascular disease in later life: umbrella review (2020) · cites this paper as [19]
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.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Endometriosis and Risk of Coronary Heart Disease > Methods > Statistical Analysis
“we stratified the association between endometriosis and combined CHD by age groups (<40, 40-50, 50-55, ≥55)”
§ Endometriosis and Risk of Coronary Heart Disease > Results > Age as a modifier on the association between endometriosis and CHD
“The relative risk was highest among women age≤40 (3.08, 2.02 to 4.70) and decreased as age increased (40<age ≤50, 1.65, 1.35 to 2.02; 50<age ≤55, 1.44, 1.07 to 1.94; age >55, 0.98, 0.56 to 1.72; p-value, test for heterogeneity=0.001).”
Citations
Cites
Inflammation, Atherosclerosis, and Coronary Artery Disease
Hansson, G. K. (2005) · New England Journal of Medicine · doi:10.1056/nejmra043430 · Cited by 8,773
Chen, X., Xiu, M., Xing, J., Yu, S., Min, D., & Guo, F. (2017) · Cellular Physiology and Biochemistry · doi:10.1159/000479439 · Cited by 5,760
Marginal Structural Models and Causal Inference in Epidemiology
Robins, J. M., Hernán, M. Á., & Brumback, B. (2000) · Epidemiology · doi:10.1097/00001648-200009000-00011 · Cited by 5,581 · cited 1×
“biased when there exist time-dependent confounders that are also affected by previous exposure.(32) For example, diet and physical activity change over time and can be influenced by previous endometriosis diagnosis.”
Heart Disease and Stroke Statistics—2014 Update
Go, A. S., Mozaffarian, D., Roger, V. L., Benjamin, E. J., Berry, J. D., Blaha, M. J., Dai, S., Ford, E. S., Fox, C. S., Franco, S., et al. (2013) · Circulation · doi:10.1161/01.cir.0000441139.02102.80 · Cited by 5,264
Giudice, L. C., & Kao, L. C. (2004) · The Lancet · doi:10.1016/s0140-6736(04)17403-5 · Cited by 3,166
Cardiovascular Survey Methods.
Rose, G., & Blackburn, H. (1968) · Annals of Internal Medicine · doi:10.7326/0003-4819-69-6-1335_2 · Cited by 3,090
Adipose Tissue, Inflammation, and Cardiovascular Disease
Berg, A. H., & Scherer, P. E. (2005) · Circulation Research · doi:10.1161/01.res.0000163635.62927.34 · Cited by 2,113 · cited 1×
“Chronic systemic inflammation contributes to vascular insult and atheromatous plaque progression.(16) Increasing evidence supports that reactive oxygen species contributes to the process of atherogenesis, as important mediators of signaling pathways that lead to vascular inflammation.”
Genomewide Association Analysis of Coronary Artery Disease
Samani, N. J., Erdmann, J., Hall, A. S., Hengstenberg, C., Mangino, M., Mayer, B., Dixon, R. J., Meitinger, T., Braund, P., Wichmann, H.-E., et al. (2007) · New England Journal of Medicine · doi:10.1056/nejmoa072366 · Cited by 2,044 · cited 1×
“Multiple independent loci in the CDKN2BAS1 (also known as ANRIL) region on chromosome 9p21 have been robustly associated with endometriosis in genome-wide association studies in Japanese and European ancestry populations,(38, 39) and has also been robustly associated with CHD outcomes.(40-42) Chr9p21 encodes the long…”
Alternative Dietary Indices Both Strongly Predict Risk of Chronic Disease
Chiuve, S. E., Fung, T. T., Rimm, E. B., Hu, F. B., McCullough, M. L., Wang, M., Stampfer, M. J., & Willett, W. C. (2012) · The Journal of Nutrition · doi:10.3945/jn.111.157222 · Cited by 1,951
Self-citationBulun, S. E. (2009) · New England Journal of Medicine · doi:10.1056/nejmra0804690 · Cited by 1,772
Research works printed but not linked: 1
- Miettinen OS. Theoretical Epidemiology: Principles of Occurrence Research. New York, NY: John Wiley & Sons; 1985.
Cited by
Sorted by citations
Endometriosis is a chronic systemic disease: Clinical challenges and novel innovations
Taylor, H. S., Kotlyar, A. M., & Flores, V. A. (2021) · The Lancet · doi:10.1016/s0140-6736(21)00389-5 · Cited by 1,425
Risk for and consequences of endometriosis: A critical epidemiologic review
Shafrir, A. L., Farland, L. V., Shah, D. K., Harris, H. R., Kvaskoff, M., Zondervan, K., & Missmer, S. A. (2018) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1016/j.bpobgyn.2018.06.001 · Cited by 823
Self-citationPathophysiology, diagnosis, and management of endometriosis
Horne, A. W., & Missmer, S. A. (2022) · BMJ · doi:10.1136/bmj-2022-070750 · Cited by 661
Self-citationTreatment of Endometriosis-Associated Pain with Elagolix, an Oral GnRH Antagonist
Taylor, H. S., Giudice, L. C., Lessey, B. A., Abrao, M. S., Kotarski, J., Archer, D. F., Diamond, M. P., Surrey, E., Johnson, N. P., Watts, N. B., et al. (2017) · New England Journal of Medicine · doi:10.1056/nejmoa1700089 · Cited by 511
Okoth, K., Chandan, J. S., Marshall, T., Thangaratinam, S., Thomas, G. N., Nirantharakumar, K., & Adderley, N. J. (2020) · BMJ · doi:10.1136/bmj.m3502 · Cited by 416
Metadata
- Authors
- Mu, F., Rich-Edwards, J., Rimm, E. B., Spiegelman, D., & Missmer, S. A.
- Affiliations
- Brigham and Women's Hospital (US)
- Venue
- Circulation: Cardiovascular Quality and Outcomes
- Published
- 2016-05
- Volume
- 9
- Issue
- 3
- Pages
- 257-264
- ISSN
- 1941-7705 (ISSN-L)
- 1941-7713
- PMC
- PMC4940126
- OpenAlex
- W2326334786
- Cited by
- 235
- References
- 56
- Citations by year
- 2026: 31 · 2025: 31 · 2024: 29 · 2023: 22 · 2022: 29 · 2021: 27 · 2020: 19 · 2019: 16 · 2018: 12 · 2017: 11 · 2016: 6
- FWCI
- 19.95
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Circulation Cardiovascular Quality and Outcomes (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- Funders
- National Cancer Institute (R01CA050385)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD057210, R01HD052473)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Infective Endocarditis Diagnosis and Management
- Keywords
- endometriosis, coronary artery disease, myocardial infarction, angina pectoris, coronary artery bypass grafting, coronary angioplasty, hysterectomy, oophorectomy, young women, chronic inflammation, oxidative stress, atherogenic lipid profile, Nurses' Health Study II, age at surgery, cardiovascular risk in women
- MeSH terms
- Adult, Age Factors, Angina Pectoris, Coronary Artery Bypass, Coronary Artery Disease, Coronary Disease, Endometriosis, Female, Humans, Hysterectomy, Longitudinal Studies, Middle Aged, Myocardial Infarction, Nurses, Ovariectomy, Laparoscopy, Prospective Studies, Risk Factors, Time Factors, United States, Stents, Treatment Outcome, Risk Assessment, Percutaneous Coronary Intervention
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.
A language model drew the claims from the paper on 2026-09-28, under version 3 of the claim definition (prompt extract-v3).
A second model labelled each claim on 2026-09-28 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Cited sources are checked with a language model’s help (gpt-6-sol).
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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