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The new tool can quickly identify at-risk patients, aiming to reduce diagnostic delays and support GPs’ clinical decision making, once clinically available.
When using the SAFE tool, age-appropriate questions target adolescent females to identify endometriosis risk factors from an earlier age.
Endometriosis carries an average of 6–8 years between onset of symptoms and diagnosis, but a new tool is showing promise in reducing diagnostic delays and supporting GPs in clinical decision making.
Developed by University of Queensland (UQ) researchers, the Simplified Adolescent Factors for Endometriosis (SAFE) score is a five-minute questionnaire to identify at-risk patient.
While it is still early days and the score is yet to be testing in a clinical setting, the tool takes girls or young women’s answers and converts them to a points-based system to help guide primary care referrals and fast-track treatment.
The evidence-based tool was designed using data from more than 9000 women from the Australian Longitudinal Study on Women’s Health, with researchers identifying risk factors for endometriosis.
‘Identifying which patients should be referred and treated is challenging and improving how patients are diagnosed is a major priority,’ project lead Professor Gita Mishra said.
‘By detecting endometriosis earlier – ideally in adolescents as soon as they begin their periods – we hope the tool will reduce the average 6–8-year diagnostic delay so we can start treatment as early as possible.’
Using the SAFE tool, young women are asked if they:
experience pelvic pain often
have often sought treatment for pelvic pain
have taken painkillers for pelvic pain
experience heavy menstrual bleeding
experience painful periods
have a family history of endometriosis.
The more risk factors identified the higher the score and greater likelihood of the condition, the study authors say, with the next steps to evaluate the tool in clinical settings – including general practices and endometriosis and pelvic pain clinics.
Women’s health expert and Head of Monash University’s Department of General Practice, Professor Danielle Mazza, told newsGP while the tool is not yet ready for implementation in clinical practice, it is ‘interesting and potentially useful’.
‘It has the benefit of potentially leading to a reduction in delay of diagnosis and delay in the commencement of treatment,’ she said.
‘And it’s targeting adolescent girls [of whom] many present in general practice with these kinds of symptoms.
‘We would hope GPs would consider the diagnosis of endometriosis and start to treat symptoms, and the guidelines recommend treatment with non-steroidal anti-inflammatories and hormonal contraceptive products.’
As Endometriosis Awareness Month is underway, further research examining the health conditions and social issues most impacting Australian females reveals the ‘silent’ condition is still tainted with a lack of understanding, recognition and support.
This is resulting in ‘discrepancies and adverse consequences for women’s and girls’ equitable access to healthcare, outcomes and research participation’.
The survey of more than 2000 women and girls identifies that endometriosis is the condition which they feel needs the most funding and support (72.9%), followed by depression (66.3%).
The UQ researchers say while the SAFE tool can be used in women of any age, age-appropriate questions have been ‘carefully chosen’ to target adolescents.
‘We need to be able to detect endometriosis early because our research found most women were diagnosed in their late twenties, often when they are trying to fall pregnant,’ Professor Mishra said.
‘Early diagnosis is critical because it can change treatment of fertility issues later on.’
Professor Mazza agrees an evaluation of the tool in the clinical setting is necessary.
‘The items they’ve identified are the expected ones … these are common things that GPs would ask about, but the researchers put together a questionnaire with a score which has a predictive value of endometriosis,’ she said.
‘They raise some interesting points, like would the potential of reducing time to diagnosis by using a questionnaire like this actually bring about unnecessary anxiety in adolescent girls?
‘So, they’ve got to test it in the clinical environment.’
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