Incidence of comorbidities among women with endometriosis: a retrospective matched cohort study

Soliman, AM; Surrey, Eric S.; Johnson, S.J.; Davis, Mark P.; Castelli-Haley, Jane; Snabes, Michael C.

doi:10.1016/j.fertnstert.2016.07.796

Cited by 2 publications

(5 citation statements)

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“…As we and others have found [ 14 – 21 ], there are a number of comorbidities in women with endometriosis. In trying to understand the meaning and implications of these comorbidities, one important dimension is the economic burden of the diseases which are comorbid in endometriosis patients.…”

Section: Discussionmentioning

confidence: 75%

“…Another potentially important aspect of endometriosis is its association with higher rates of a spectrum of comorbid conditions [ 14 ], including ovarian and other gynecological cancers [ 15 ], thyroid cancer, autoimmune diseases, asthma/atopic diseases, and cardiovascular diseases [ 16 – 21 ]. Medical care for each disease by itself can be expensive [ 22 – 25 ].…”

Section: Introductionmentioning

confidence: 99%

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Changes in Healthcare Spending After Diagnosis of Comorbidities Among Endometriosis Patients: A Difference-in-Differences Analysis

Epstein¹,

Soliman

Davis³

et al. 2017

Adv Ther

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IntroductionWe sought to characterize changes in healthcare spending associated with the onset of 22 endometriosis-related comorbidities.MethodsWomen aged 18–49 years with endometriosis (N = 180,278) were extracted from 2006–2015 de-identified Clinformatics® DataMart claims data. For 22 comorbidities, comorbidity patients were identified on the basis of having a first comorbidity diagnosis after their initial endometriosis diagnosis. Controls were identified on the basis of having no comorbidity diagnosis and were matched 1:1 to comorbidity patients on demographics and baseline spending. Total medical and pharmacy spending was measured during 12 months before and after each patient’s index date (first comorbidity diagnosis for comorbidity patients, and equal number of days after earliest endometriosis claim for controls). Pre–post spending differences were compared using difference-in-differences linear regression. Total and comorbidity-related cumulative spending per patient for all endometriosis patients were calculated annually for the 5 years following endometriosis diagnosis.ResultsThe number of endometriosis patients with each comorbidity varied between 121 for endometrial cancer and 16,177 for fatigue. Healthcare spending increased significantly with the onset of eight comorbidities: breast cancer, ovarian cancer, pregnancy complications, systemic lupus erythematosus/rheumatoid arthritis/Sjogren’s/multiple sclerosis, infertility, uterine fibroids, ovarian cyst, and headache [p < 0.001 except for headache (p = 0.045)]. Spending decreased significantly for fatigue, cystitis/UTI, and eczema [p < 0.001 except for fatigue (p = 0.048)] and was not statistically different for the other 11 comorbidities. Difference-in-differences estimates were significantly higher for comorbidity patients for all comorbidities except eczema (p ≤ 0.003). Mean 5-year total cumulative spending was $58,191 per endometriosis patient, of which between 11% and 23% was attributable to comorbidity-related medical claims.ConclusionFor all but one of the 22 comorbidities associated with endometriosis, comorbidity onset was associated with a relative increase in total healthcare spending.FundingAbbVie Inc.Electronic supplementary materialThe online version of this article (doi:10.1007/s12325-017-0630-8) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 75%

Section: Introductionmentioning

confidence: 99%

Changes in Healthcare Spending After Diagnosis of Comorbidities Among Endometriosis Patients: A Difference-in-Differences Analysis

Epstein¹,

Soliman

Davis³

et al. 2017

Adv Ther

View full text Add to dashboard Cite

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“…Endometriosis develops when endometrial cells travel from the uterine cavity to ectopic sites outside the uterine lining, embed and grow into endometriosis lesions ( 5 , 10 ). These lesions respond to hormonal signals during menstrual cycles or pregnancy, proliferating in the presence of estrogens and androgens and receding in the presence of progesterone.…”

Section: Introductionmentioning

confidence: 99%

“…It is commonly reported that 10% of menstruating adolescent and adult females have endometriosis ( 5 , 6 ). But there is tremendous variation in the reported incidence and prevalence of endometriosis based on the study population, specialty of the diagnosing clinician, and diagnostic procedures ( 12 , 17 – 20 ).…”

Section: Introductionmentioning

confidence: 99%

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Leveraging electronic health record data for endometriosis research

Penrod

Okeh²,

Edwards

et al. 2023

Front. Digit. Health

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Endometriosis is a chronic, complex disease for which there are vast disparities in diagnosis and treatment between sociodemographic groups. Clinical presentation of endometriosis can vary from asymptomatic disease—often identified during (in)fertility consultations—to dysmenorrhea and debilitating pelvic pain. Because of this complexity, delayed diagnosis (mean time to diagnosis is 1.7–3.6 years) and misdiagnosis is common. Early and accurate diagnosis of endometriosis remains a research priority for patient advocates and healthcare providers. Electronic health records (EHRs) have been widely adopted as a data source in biomedical research. However, they remain a largely untapped source of data for endometriosis research. EHRs capture diverse, real-world patient populations and care trajectories and can be used to learn patterns of underlying risk factors for endometriosis which, in turn, can be used to inform screening guidelines to help clinicians efficiently and effectively recognize and diagnose the disease in all patient populations reducing inequities in care. Here, we provide an overview of the advantages and limitations of using EHR data to study endometriosis. We describe the prevalence of endometriosis observed in diverse populations from multiple healthcare institutions, examples of variables that can be extracted from EHRs to enhance the accuracy of endometriosis prediction, and opportunities to leverage longitudinal EHR data to improve our understanding of long-term health consequences for all patients.

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Incidence of comorbidities among women with endometriosis: a retrospective matched cohort study

Cited by 2 publications

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Changes in Healthcare Spending After Diagnosis of Comorbidities Among Endometriosis Patients: A Difference-in-Differences Analysis

Changes in Healthcare Spending After Diagnosis of Comorbidities Among Endometriosis Patients: A Difference-in-Differences Analysis

Leveraging electronic health record data for endometriosis research

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