Main findings
This meta-analysis presents an up-to-date, large, and geographically
varied data set identifying predictive factors for diagnosis of pelvic
endometriosis with a high degree of confidence. Index tests showed a
positive association with endometriosis and trended towards a greater
specificity than sensitivity, excluding elevated BMI, which demonstrated
an inverse correlation. TVUSS finding of endometrioma reached a desired
threshold for use as a ‘rule-in’ test and none achieved a summary
sensitivity of >95% for ‘rule-out’. A family history of
endometriosis, dyschezia and serum CA-125 >35U/mL showed
summary specificity of >90% although low sensitivity.
Sensitivity was poor for symptom and clinical history tests, where the
best performing was dysmenorrhoea.