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Trial registered on ANZCTR
Registration number
ACTRN12621000357853
Ethics application status
Approved
Date submitted
9/02/2021
Date registered
30/03/2021
Date last updated
30/03/2021
Date data sharing statement initially provided
30/03/2021
Type of registration
Prospectively registered
Titles & IDs
Public title
Predicting absence of endometriosis in people with pelvic pain
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Scientific title
Developing and evaluating a screening tool to improve pre-operative prediction of absence of endometriosis in people with pelvic pain
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Secondary ID [1]
303277
0
nil known
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Universal Trial Number (UTN)
U1111-1264-3857
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
pelvic pain
320471
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endometriosis
320472
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Condition category
Condition code
Reproductive Health and Childbirth
318356
318356
0
0
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Other reproductive health and childbirth disorders
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Renal and Urogenital
319089
319089
0
0
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Other renal and urogenital disorders
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
People planned to have laparoscopy for investigation and/or management of pelvic pain will complete a questionnaire about their demographics and symptoms. This will take approximately 20-25 minutes to complete. It will be completed pre-operatively from anytime once they are booked for surgery/placed on the surgical waiting list. Participants will have their anogenital distance measured once they are asleep under anaesthetic immediately prior to their surgery commencing, at the time of routine pre-operative examination. It will take approximately 1 minute for the anogenital distance to be measured. At laparoscopy it will be documented if endometriosis is present or absent. Pre-operative variables collected will be used to create a predictive model for absence of endometriosis.
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Intervention code [1]
319579
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Diagnosis / Prognosis
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
326493
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Accuracy of predictive model in predicting absence of endometriosis (measured in sensitivity, specificity, positive and negative predictive values and area under the receiver operating characteristic - ROC - curve). The definitive "endometriosis diagnosis" will be made with combination of laparoscopic and histopathological findings, as described in detail in the table on pages 14-15 of the study protocol. In most cases a "true" endometriosis diagnosis requires both positive visual appearance at laparoscopy and positive histopathological report.
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Assessment method [1]
326493
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Timepoint [1]
326493
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At time of laparoscopy and histopathalogical report
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Secondary outcome [1]
391685
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Anogential distance assessed to millimetre accuracy using measuring tape
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Assessment method [1]
391685
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Timepoint [1]
391685
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At time of laparoscopy
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Secondary outcome [2]
393324
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Presence of endometriosis determined by visual appearance at laparoscopy and histopathalogical findings
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Assessment method [2]
393324
0
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Timepoint [2]
393324
0
At time of laparoscopy and histopathalogical report
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Eligibility
Key inclusion criteria
• Women aged 18 – 45 planned to undergo laparoscopy for investigation and/or management of pelvic pain
• Pelvic ultrasound performed within 12 months of recruitment with no evidence of endometrioma/s and/or deep infiltrating endometriosis
o Both specialist quality and community quality ultrasound included
• Women with a previous laparoscopy for investigation of pelvic pain and women with a previous diagnosis of endometriosis remain eligible
• Women with both current and previous hormone use remain eligible
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Minimum age
18
Years
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Maximum age
45
Years
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Sex
Females
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Can healthy volunteers participate?
No
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Key exclusion criteria
• Unable to provide consent
• Previous participation in the same study
• Post-menopausal
• Pelvic ultrasound showing another likely cause for pain that would independently warrant laparoscopy (eg evidence of tubo-ovarian abscess, hydrosalpinx, other ovarian cyst, fibroid warranting myomectomy).
• Evidence on ultrasound of endometriosis (endometrioma or DIE)
• Unable to obtain report of pelvic ultrasound
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Study design
Purpose
Screening
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Duration
Cross-sectional
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
Initial analysis will involve examining associations between categorical variables using chi-squared tests. For continuous variables, comparisons between subgroups will be conducted using t-tests or their nonparametric analogues. ROC curves will be used to assess best cut-off points. To build the final discriminatory tool/s we will use machine learning and regression modelling to assess the interactions of potential variables of interest associated with presence and absence of endometriosis. P value of <0.05 will be considered significant. We will experiment with different types and models of machine learning algorithms. The final “tool” will be presented with measures of sensitivity, specificity, positive predictive value & negative predictive value. This analysis will be performed on 50% of cases, a “model training” set, then the tool will be applied to the 2nd 50% of cases, a “confirmation” set, to reassess its sensitivity, specificity, positive predictive value & negative predictive value. This is to avoid “overfitting”. All cases will be used to calculate confidence intervals on the diagnostic measures.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
19/04/2021
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Actual
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Date of last participant enrolment
Anticipated
1/09/2024
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Actual
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Date of last data collection
Anticipated
1/02/2025
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Actual
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Sample size
Target
666
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
18669
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Mercy Hospital for Women - Heidelberg
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Recruitment hospital [2]
18670
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The Royal Women's Hospital - Parkville
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Recruitment hospital [3]
18671
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Epworth Freemasons (Victoria Parade) - East Melbourne
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Recruitment hospital [4]
18672
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Frances Perry House - Parkville
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Recruitment hospital [5]
18673
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Epworth Richmond - Richmond
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Recruitment hospital [6]
18674
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Warringal Private Hospital - Heidelberg
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Recruitment hospital [7]
18675
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Sunshine Hospital - St Albans
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Recruitment hospital [8]
18676
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St Vincent's Hospital (Melbourne) Ltd - Fitzroy
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Recruitment hospital [9]
18677
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Holmesglen Private Hospital - Moorabbin
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Recruitment hospital [10]
18678
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Cabrini Hospital - Malvern - Malvern
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Recruitment hospital [11]
18679
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Northpark Private Hospital - Bundoora
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Recruitment hospital [12]
18680
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Peninsula Private Hospital - Frankston - Frankston
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Recruitment hospital [13]
18681
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Beleura Private Hospital - Mornington
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Recruitment postcode(s) [1]
33107
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3084 - Heidelberg
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Recruitment postcode(s) [2]
33108
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3052 - Parkville
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Recruitment postcode(s) [3]
33109
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3002 - East Melbourne
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Recruitment postcode(s) [4]
33110
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3121 - Richmond
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Recruitment postcode(s) [5]
33111
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3021 - St Albans
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Recruitment postcode(s) [6]
33112
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3065 - Fitzroy
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Recruitment postcode(s) [7]
33113
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3189 - Moorabbin
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Recruitment postcode(s) [8]
33114
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3144 - Malvern
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Recruitment postcode(s) [9]
33115
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3083 - Bundoora
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Recruitment postcode(s) [10]
33116
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3199 - Frankston
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Recruitment postcode(s) [11]
33117
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3931 - Mornington
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Recruitment outside Australia
Country [1]
23447
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Israel
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State/province [1]
23447
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Jerusalem
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Funding & Sponsors
Funding source category [1]
307688
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University
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Name [1]
307688
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The University of Melbourne
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Address [1]
307688
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Department of Obstetrics and Gynaecology
The University of Melbourne
Parkville
VIC 3010
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Country [1]
307688
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Australia
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Primary sponsor type
Hospital
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Name
The Royal Women's Hospital
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Address
20 Flemington Rd
Parkville
VIC 3052
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Country
Australia
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Secondary sponsor category [1]
308387
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University
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Name [1]
308387
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The University of Melbourne
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Address [1]
308387
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Parkville
VIC 3010
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Country [1]
308387
0
Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
307723
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Austin Health Human Research Ethics Committee
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Ethics committee address [1]
307723
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145 Studley Rd PO Box 5555 Heidelberg VIC 3084
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Ethics committee country [1]
307723
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Australia
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Date submitted for ethics approval [1]
307723
0
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Approval date [1]
307723
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27/08/2020
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Ethics approval number [1]
307723
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ND 66627/2020
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Summary
Brief summary
Endometriosis is an important and common cause for pelvic pain for which laparoscopy provides definitive diagnosis and often symptom relief. There are however many people with pelvic pain who do not have endometriosis in whom laparoscopy poses potential risks and costs without the same possibility for symptom benefit. As yet, there are no validated, symptom-based, patient-reported questionnaires for endometriosis screening. We plan to make a predictive tool that uses questions about a person’s symptoms and medical history and their anogenital distance (AGD – the distance from the vagina to the anus which is associated with chance of endometriosis), to better predict pre-operatively the absence of endometriosis. This could hopefully be used as a tool that women could use to help decide if they want to go on and have a laparoscopy or not. It might result in fewer women having unnecessary surgery and getting more appropriate treatment for their pain instead. In this study we will look at people already planning to have a laparoscopy for investigation of their pelvic pain. We will ask them to fill in a questionnaire about their symptoms and medical history before their operation and then we will check if they had endometriosis at surgery or not. We will also measure their anogenital distance while they are asleep under the anaesthetic for their surgery. We will use this information to develop and validate a predictive tool for absence of endometriosis.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
108278
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Dr Charlotte Reddington
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Address
108278
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Suite 2, Level 2
The Royal Women's Hospital
20 Flemington Rd
Parkville
VIC 3052
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Country
108278
0
Australia
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Phone
108278
0
+61 413296553
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Fax
108278
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+61393482633
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Email
108278
0
[email protected]
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Contact person for public queries
Name
108279
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Charlotte Reddington
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Address
108279
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Suite 2, Level 2
The Royal Women's Hospital
20 Flemington Rd
Parkville
VIC 3052
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Country
108279
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Australia
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Phone
108279
0
+61 3 93482833
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Fax
108279
0
+61393482633
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Email
108279
0
[email protected]
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Contact person for scientific queries
Name
108280
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Charlotte Reddington
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Address
108280
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Suite 2, Level 2
The Royal Women's Hospital
20 Flemington Rd
Parkville
VIC 3052
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Country
108280
0
Australia
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Phone
108280
0
+61 3 93482833
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Fax
108280
0
+61393482633
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Email
108280
0
[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
10531
Study protocol
381305-(Uploaded-09-02-2021-18-22-24)-Study-related document.pdf
10532
Informed consent form
381305-(Uploaded-09-02-2021-18-22-36)-Study-related document.pdf
10533
Ethical approval
381305-(Uploaded-09-02-2021-18-22-47)-Study-related document.pdf
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF