Are the studies based on the nationwide databases more accurate?

A recent editorial discusses the issue, comparing centered studies with nationwide studies

Key Points

Highlight

• The results of different studies should be approached with caution when taking the results into daily practice. 

Importance

• Each study has its advantages and disadvantages in providing surgeons with new knowledge that can be applied in daily practice.
• Nationwide databases tend to provide more accurate information regarding the prevalence, whereas centered studies offer new knowledge on different surgical techniques.

What’s done here

• It’s an editorial letter written about the surgical interventions for ovarian endometrioma and how they should be selected depending on the results from different studies.
• Studies that included the data of one or more surgical teams and studies that were performed using the data of the nationwide databases were compared.

Key results

• The studies performed with the data from one or more surgical teams tend to report the best-expected outcomes that were performed by very experienced surgeons in big centers.
• Caution must be taken when applying these in daily practice because of the possibility of a less similar outcome in the hands of inexperienced surgeons.
• Studies that use the data from nationwide databases are more likely to be accurate regarding the prevalence, the number of patients, and the number of procedures performed over the years.
• The results of nationwide studies may help develop training courses for the surgeons who want to improve the treatment of endometriosis.

Lay Summary

One of the most common localizations of endometriosis is the ovaries, and therefore, ovarian endometriomas are among the most surgically treated endometriotic lesions.

Dr. Roman from Denmark has recently written an editorial about the surgical interventions on ovarian endometrioma and how they should be selected depending on the results from different studies. He compared studies that included the data of one or more surgical teams to studies that were performed using the data of the nationwide databases. It was published in the February 2022 issue of the journal Fertility and Sterility.

The surgical procedure for every ovarian endometrioma should be selected carefully, taking into account many different features such as age, pregnancy intention, ovarian reserve, and the presence of recurrence. Dr. Roman touches on the subject that bilateral oophorectomies are no longer agreed upon as a surgical option because there is evidence of long-term unfavorable results.

The studies performed with the data from one or more surgical teams provide some information about the surgical procedures in question; however, they tend to report the best-expected outcomes that very experienced surgeons in big centers performed. It is recommended that caution must be taken when applying these in daily practice because of the possibility of a less similar outcome in the hands of inexperienced surgeons.

On the other hand, studies that use the data from nationwide databases are more likely to be accurate regarding the prevalence, the number of patients, and the number of procedures performed over the years. These studies tend to focus on a limited number of procedures in the management of the diseases; hence, more recent surgical techniques might be overlooked.

Dr. Roman concludes by referring to a nationwide study whose results might provide information that may aid in developing training courses for the surgeons who want to improve the treatment of endometriosis.

Research Source: https://pubmed.ncbi.nlm.nih.gov/34980430/