Establishment And Preliminary Application Of The "Electronic Follow-Up Platform Database For Endometriosis"

BackgroundEndometriosis(referred to as endometriosis)is defined as the growth of endometrium-like tissue(endometrial glands and stroma)in different locations outside the uterine cavity.As an estrogen-dependent and chronic gynecological disorder commonly seen in women of reproductive age,endometriosis usually presents with CPP,dysmenorrhea,dyspareunia and infertility,which place a significant burden on their physical and mental health,economic situation,and social life.The impact of OMA itself and its surgical treatment on ovarian reserve function in female patients of reproductive age requires the attention of specialists.Due to the prolonged course,the difficulty of radical surgery,the high recurrence rate after surgery and the risk of malignant transformation,endometriosis requires long-term medication and standardized follow-up management.Restrictions on the mobility of society and difficulties in accessing medical resources caused by the COVID-19 pandemic made the follow-up management of endometriosis even more difficult,it was difficult to meet the needs of both clinicians and patients with conventional management methods,therefore,there is a trend to establish a new model of follow-up management of endometriosis.ObjectiveTo introduce the establishment and preliminary application of a new endometriosis followup management model during the COVID-19 pandemic—the electronic follow-up(e-followup)platform database for endometriosis,and to test the applicability and patient satisfaction of the new follow-up management model,as well as to conduct a study of changes in ovarian reserve function after laparoscopic OMA stripping using the platform database function.Materials and MethodsThe investigators(clinicians)collaborated with Zero Krypton Technology(Beijing)Ltd.to design a CDM for endometriosis,which was used as the basis to develop the e-follow-up platform database for endometriosis.From January 2021 to January 31,2023,the investigators used the follow-up platform database for information entry and postoperative follow-up of patients with endometriosis receiving long-term hormonal medication after surgery.We used VAS,SDS and SAS to assess participants’ pain intensity,depression and anxiety levels.Main observation indicators at follow-up:(1)changes in participants’ VAS,SDS,and SAS scores preoperatively and after 6 months of postoperative follow-up;(2)participants’ follow-up satisfaction and scores on the need for the existence of the platform after 6 months of postoperative follow-up;(3)the cumulative number of recurrences at 6 months and 1 year postoperatively.Main observation indicators for the study of changes in ovarian reserve function after laparoscopic OMA stripping:(1)changes in serum AMH levels 1 month after laparoscopic OMA stripping and the factors affecting them;(2)trends in serum AMH levels 3/6/12 months after laparoscopic OMA stripping.Results1.The follow-up platform database was successfully established and online for preliminary application,with a total of 152 postoperative endometriosis patients included as of January 31,2023,and 14 participants were lost to follow-up with a rate of 9.2%(<10.0%),138 participants completed 6-month postoperative follow-up.and a total of 95 participants completed 1-year postoperative follow-up;2.Participants’ VAS(P<0.001),SDS(P<0.001)and SAS(P<0.001)scores were significantly decreased after completing the 6 months follow-up compared to preoperative;3.Participants’ follow-up satisfaction rate reached 100%,with 90.58%expressing great satisfaction,86.70%of participants indicated that the presence of the platform was very necessary;4.The cumulative numbers of recurrences within 6 months and 1 year postoperatively were 0 and 3,respectively,and the recurrence rate within 1 year after surgery was 3.16%(3/95);5.Serum AMH levels decreased significantly at 1 month after laparoscopic OMA stripping(P<0.001),the degree of decrease was significantly higher bilaterally than unilaterally,and the percentage decrease in serum AMH at 1 month postoperatively was positively correlated with serum CA 125 level(r=0.291,P=0.01)and r-ASRM score(r=0.368,P=0.001);there was no apparent further decrease in serum AMH levels at 3/6/12 months postoperative follow-up(P>0.05),and the percentage of patients who showed a rebound increased with longer follow-up duration.ConclusionsThe successful establishment of the follow-up platform database and the new follow-up management model have broken the time and space constraints of follow-up work during the COVID-19 pandemic,enabled endometriosis patients to access medical resources more effectively,greatly reduced the impact of COVID-19 on the follow-up management of endometriosis,enhanced the efficiency of follow-up management,alleviated participants’anxiety and depression,and has received good feedback form the participants.The study on the changes of ovarian reserve function after laparoscopic OMA stripping using the platform database function suggests that the effect of surgery on ovarian reserve function in OMA patients is inevitable in the short term but not irrecoverable,and long-term follow-up observation is recommended.The establishment of the platform database can be further used for in-depth research on prospective and retrospective topics of endogeneity,which improves the efficiency of research.