Translation and psychometric evaluation of the simplified Chinese-version Endometriosis Health Profile-30.

STUDY QUESTION: What are the psychometric properties in mainland China of the 30-item Endometriosis Health Profile (EHP-30) translated into simplified Chinese? SUMMARY ANSWER: The simplified Chinese version of the EHP-30 is a valid, reliable and acceptable tool for the measurement of the health-related quality of life (HRQoL) of women with endometriosis in the context of mainland China. WHAT IS KNOWN ALREADY: Endometriosis can critically affect women's HRQoL. The EHP-30 is currently the most reliable instrument to measure the HRQoL in women with endometriosis. STUDY DESIGN, SIZE, DURATION: This cross-sectional study was conducted in a tertiary referral university hospital from February 2012 to August 2012 in Beijing, P. R. China. PARTICIPANTS/MATERIALS, SETTING, METHODS: The translation and cultural adaptation of the EHP-30 was performed according to accepted guidelines. The study included 336 women with endometriosis. Psychometric evaluation included factor analysis, convergent validity, measurement of internal consistency, item-total correlations and data completeness, descriptive statistics, and the determination of floor and ceiling effects. MAIN RESULTS AND THE ROLE OF CHANCE: Factor analysis confirmed the validity of the five-factor structure of the EHP-30 core questionnaire, which explained 79.51% of the total variance. The correlations of related subscale scores between EHP-30 and Short Form-36 were all significant. Cronbach's α for internal consistency across each scale ranged 0.89-0.97 for the core questionnaire and 0.80-0.96 for the modular questionnaire. No <97.67% of data completeness was achieved. Floor effects were observed in three scales: self-image (19.64%), children (26.67%) and medical profession (15.19%). No ceiling effects were found. The control and powerlessness scale had the highest median score (54.17) in the core questionnaire, whereas the infertility module (median = 56.25) had the highest score in the modular section. LIMITATIONS, REASONS FOR CAUTION: The study was conducted in a referral centre for the treatment of endometriosis, thereby leading to overrepresentation of severe symptoms of endometriosis. Furthermore, the test-retest reliability and responsiveness of the questionnaire were not evaluated in this study. WIDER IMPLICATIONS OF THE FINDINGS: Our study addresses the urgent need for a valid and reliable instrument to measure the HRQoL of female patients with endometriosis in mainland China. STUDY FUNDING/COMPETING INTEREST(S): This work was supported by grants to J. Leng from the Key Project for Clinical Faculty Foundation, Ministry of Health, China (2010). None of the authors has any conflict of interest to declare.

Genome-wide profiling of long noncoding ribonucleic acid expression patterns in ovarian endometriosis by microarray.

OBJECTIVE: To profile the long noncoding RNA (lncRNA) expression patterns in ovarian ectopic endometrial tissue compared with paired eutopic endometrial tissue. DESIGN: Genome-wide expression analysis of human tissue. SETTING: University hospital. PATIENT(S): Twenty-five patients receiving laparoscopic surgeries for ovarian endometriosis. INTERVENTION(S): Ovarian ectopic endometrial tissue was obtained during surgery. Eutopic endometrial tissue was taken by curettage at the same time. MAIN OUTCOME MEASURE(S): Ectopic and eutopic endometrial lncRNA and messenger RNA (mRNA) expression levels were determined by microarray in four patients; quantitative reverse transcription-polymerase chain reaction validation of 10 differentially expressed lncRNAs was conducted in another 21 patients. The lncRNAs' functions were predicted through coexpressed mRNA annotations. RESULT(S): A total of 948 lncRNA transcripts and 4,088 mRNA transcripts were dysregulated in ectopic endometrial tissue, compared with paired eutopic endometrial tissue. The expressions of the 10 chosen lncRNAs were validated by quantitative reverse transcription-polymerase chain reaction. Functional analysis suggests that several groups of lncRNAs may participate in biological pathways related to endometriosis by cis- and/or trans-regulation of protein-coding genes. CONCLUSION(S): This study constitutes the first report of lncRNA expression patterns in human ectopic and eutopic endometrial tissue. Nearly 1,000 dysregulated lncRNA transcripts are found by microarray.

Prevalence and associated factors of female sexual dysfunction in women with endometriosis.

OBJECTIVE: The issue of female sexual function is often overlooked in women with endometriosis, especially in mainland China. The objectives of this study were to estimate the prevalence and associated factors of female sexual dysfunction in endometriosis in China. METHODS: This cross-sectional study was conducted at a referral university hospital in Beijing, Peoples Republic of China from July 2011 to April 2012. Women were recruited among inpatients scheduled for laparoscopic surgery based on signs and symptoms suggestive of endometriosis. Before laparoscopy, a semi-structured questionnaire was used to collect demographic data and disease characteristics. The simplified Chinese version of the Female Sexual Function Index was used to assess sexual function. RESULTS: A total of 111 consecutive women with histologically confirmed endometriosis were enrolled in this study. The prevalence of female sexual dysfunction was 73% for those with endometriosis. Univariable analysis identified three potential predictors of female sexual dysfunction: pelvic pain intensity; deep infiltrating endometriosis status; and revised American Society for Reproductive Medicine stages. Multivariable analysis showed that moderate-to-severe pelvic pain (adjusted odds ratio [OR] 3.4, 95% confidence interval [CI] 1.3-8.8) and revised American Society for Reproductive Medicine stage III or IV (adjusted OR 4.4, 95% CI 1.3-15.5) were associated with increased risk of having female sexual dysfunction. CONCLUSION: Female sexual dysfunction is common in women with endometriosis, especially for those with severe pelvic pain and advanced stages of endometriosis.

Health-related quality of life in women with endometriosis: a systematic review.

Endometriosis has critical implications for women's quality of life. However, an overview of the current knowledge of this issue is limited. The objective of this systematic review was to determine the extent of endometriosis and its treatment upon women's health-related quality of life (HRQoL). PubMed, Embase, PsycoINFO, CINAHL and the Cochrane Clinical Trials were searched up to May 2012, and only studies using standardized instruments to evaluate HRQoL in women with endometriosis were selected. Our electronic searches identified 591 citations, of which 39 studies satisfied the inclusion criteria including nine qualitative studies and 30 treatment-related studies. Findings showed that endometriosis impaired women's HRQoL. Pain was strongly related to a poor HRQoL, and medical or surgical treatment could partially restore this impairment. No conclusive evidence was available on whether endometriosis imposed an additional impairment in HRQoL per se, apart from the decrease caused by chronic pelvic pain, or on the superiority of various hormonal suppression agents. The impacts of disease extent, duration and fertility status upon HRQoL were inconsistent. In summary, HRQoL was impaired in women with endometriosis, and medical or surgical treatment to alleviate pain could partially restore this impairment.