{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T00:28:43Z","timestamp":1783556923858,"version":"3.55.0"},"reference-count":39,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T00:00:00Z","timestamp":1766188800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: The assessment of endometriosis (EMS)-associated pain is important, but only very few studies address the potential use of questionnaires for non-invasive prediction of the disease. Methods: In a prospective observational study from 2016 to 2024 with patients (n = 228) using hormonal contraception, all women with suspected EMS answered two questionnaires and were examined physically and with transvaginal ultrasound (TVUS). If deep infiltrating EMS (DIE) was suspected, magnetic resonance imaging (MRI) was performed. EMS diagnosis was confirmed by histological examination. Statistical analysis was mainly performed using 2 \u00d7 2 contingency tables. The decision tree was created manually. Results: The mean numerical rating scales (NRSs) of EMS-positive compared to EMS-negative patients were ~4-fold higher (4.45 and 1.15, respectively). Patients with EMS have, significantly, ~3 times more significant parameters compared to patients without EMS (18.5 and 5.9, respectively). In combination with dysuria and lightning-like pain, this resulted in very good prediction. A decision tree yielded a sensitivity of 0.924, a specificity of 0.917, a positive predictive value (PPV) of 0.924, a negative predictive value (NPV) of 0.917, and a positive likelihood ratio of 11.2, indicating a very good diagnostic test. There is no typical endometriosis pain, but various pain patterns are predictive of EMS. Conclusions: Thus, a reliable non-invasive EMS diagnosis by questionnaires is possible and could reduce the delay in the detection of EMS.<\/jats:p>","DOI":"10.3390\/jcm15010030","type":"journal-article","created":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T11:43:31Z","timestamp":1766403811000},"page":"30","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Non-Invasive Diagnosis of Endometriosis by Questionnaires in Patients Using Contraception"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2909-9492","authenticated-orcid":false,"given":"Felix","family":"Zeppernick","sequence":"first","affiliation":[{"name":"Institute of Gynecology and Obstetrics, Faculty of Medicine, Justus Liebig University Giessen, Feulgenstr. 10-12, 35392 Giessen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8638-4303","authenticated-orcid":false,"given":"Samira","family":"Balimuttajjo","sequence":"additional","affiliation":[{"name":"Institute of Gynecology and Obstetrics, Faculty of Medicine, Justus Liebig University Giessen, Feulgenstr. 10-12, 35392 Giessen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Schorr","sequence":"additional","affiliation":[{"name":"Deutsches Forschungszentrum f\u00fcr K\u00fcnstliche Intelligenz GmbH, DFKI Saarland Informatics Campus D3.2, 66123 Saarbr\u00fccken, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2682-4432","authenticated-orcid":false,"given":"Florian","family":"Sibelius","sequence":"additional","affiliation":[{"name":"Deutsches Forschungszentrum f\u00fcr K\u00fcnstliche Intelligenz GmbH, DFKI Saarland Informatics Campus D3.2, 66123 Saarbr\u00fccken, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuela","family":"Schuler","sequence":"additional","affiliation":[{"name":"Deutsches Forschungszentrum f\u00fcr K\u00fcnstliche Intelligenz GmbH, DFKI Saarland Informatics Campus D3.2, 66123 Saarbr\u00fccken, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5272-2716","authenticated-orcid":false,"given":"Sebastian","family":"Harth","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Justus Liebig University Giessen, 35390 Giessen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Seeger","sequence":"additional","affiliation":[{"name":"Institute of Gynecology and Obstetrics, Faculty of Medicine, Justus Liebig University Giessen, Feulgenstr. 10-12, 35392 Giessen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"L\u00f6ffelmann","sequence":"additional","affiliation":[{"name":"Institute of Gynecology and Obstetrics, Faculty of Medicine, Justus Liebig University Giessen, Feulgenstr. 10-12, 35392 Giessen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad A.","family":"Riaz","sequence":"additional","affiliation":[{"name":"Institute of Gynecology and Obstetrics, Faculty of Medicine, Justus Liebig University Giessen, Feulgenstr. 10-12, 35392 Giessen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0331-8781","authenticated-orcid":false,"given":"Ivo","family":"Meinhold-Heerlein","sequence":"additional","affiliation":[{"name":"Institute of Gynecology and Obstetrics, Faculty of Medicine, Justus Liebig University Giessen, Feulgenstr. 10-12, 35392 Giessen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5878-3050","authenticated-orcid":false,"given":"Lutz","family":"Konrad","sequence":"additional","affiliation":[{"name":"Institute of Gynecology and Obstetrics, Faculty of Medicine, Justus Liebig University Giessen, Feulgenstr. 10-12, 35392 Giessen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1097\/PAP.0b013e3180ca7d7b","article-title":"The pathology of endometriosis: A survey of the many faces of a common disease emphasizing diagnostic pitfalls and unusual and newly appreciated aspects","volume":"14","author":"Clement","year":"2007","journal-title":"Adv. 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