Use of the Free Endometriosis Risk Advisor App as a Non-Invasive Screening Test for Endometriosis in Patients with Chronic Pelvic Pain and/or Unexplained Infertility

Abstract

Endometriosis is a prevalent condition that affects millions of individuals globally, leading to various symptoms and significant disruptions to their quality of life. However, the diagnosis of endometriosis often encounters delays, emphasizing the pressing need for non-invasive screening. This retrospective cross-sectional study aimed to evaluate the utility of the Endometriosis Risk Advisor (EndoRA) mobile application in screening for endometriosis in patients with chronic pelvic pain and/or unexplained infertility. The study consisted of 293 patients who met specific criteria: they were English-speaking individuals with chronic pelvic pain and/or unexplained infertility, owned smartphones, and had no prior diagnosis of endometriosis. The results demonstrated that the EndoRA score exhibited a high sensitivity of 93.1% but a low specificity of 5.9% in detecting endometriosis. The positive predictive value was 94.1%, while the negative predictive value was 5.0%. Although the study had limitations and potential selection bias, its findings suggest that EndoRA can serve as a valuable screening tool for high-risk individuals, enabling them to identify themselves as being at an increased risk for endometriosis. EndoRA’s non-invasive nature, free access, and easy accessibility have the potential to streamline evaluation and treatment processes, thereby empowering individuals to seek timely care and ultimately improving patient outcomes and overall well-being.

The Prevalence of Endometriosis in Patients with Unexplained Infertility

“…Hence, every attempt should be made for the diagnosis of endometriosis as early as possible. The introduction of dependable, non-invasive, and cost-effective endometriosis markers or screening tools may enhance our diagnostic capabilities, particularly in cases of unexplained infertility [39][40][41][42]. This advancement empowers healthcare providers to comprehensively manage endometriosis patients for both obstetric and non-obstetric conditions.…”

“…However, if physicians were able to screen for or diagnose endometriosis with high accuracy non-invasively, it may affect their patients' management. Non-invasive methods, including but not limited to saliva testing, endometrial function testing, the Nezhat Endometriosis Risk Advisor (EndoRA) mobile application, and BCL6 testing, can be highly suggestive of endometriosis [40][41][42][43]. Other non-invasive diagnosis methods are also currently being researched, such as the use of transforming growth factor-β-induced protein ig-h3 (TGFBI) as a biomarker for endometriosis, or using Fourier transform infrared vibrational spectroscopy to study the association between protein and lipid fraction and endometrioma volume [44,45].…”