Patient and Practitioner: The Impact of Social Factors on Diagnostic Delay for Endometriosis
Bibliographic record
Abstract
Introduction: Endometriosis is a gynaecological disease with diverse symptoms that are often shared with other disorders and is characterized by long diagnostic delays. Delayed diagnosis prevents patients from receiving access to care and negatively impacts both physical and mental health. While technical limitations of the diagnostic procedure contribute to the delay, there is also significant delay in first seeking consultation as well as getting referred to specialized care that point to social differences rather than medical factors. This literature review aims to identify social determinants that contribute to these delays in endometriosis diagnosis. Methods: A literary search was conducted using PubMed, PsycInfo, and Web of Science. The search yielded a total of 549 articles. Of these, 22 articles were selected based on established search terms and criteria including that the articles had to present original data, be written in English, be published no earlier than 2012, and have full-text availability. Results: Factors contributing to diagnostic delay can be related to one of two groups: the patient and the practitioner Patient factors that increase delay include certain demographic characteristics, the extent of pain normalization, the stigma surrounding women’s health, and the lack of self-advocacy. Practitioner factors that increase diagnostic delay include dismissive attitudes, the lack of knowledge and technical competence concerning endometriosis, and their relationship with patients as a position of authority. Discussion: Many identified factors share similar themes but are manifested differently amongst patients and practitioners, particularly those relating to the lack of familiarity with endometriosis and the normalization or dismissal of symptoms. Shared findings point to larger societal factors influencing both patients and practitioners. Conclusion: The findings of this review provide insight into social determinants that contribute to the long delays associated with endometriosis diagnosis. Future research should be aimed at establishing interventions for identified factors and also address larger shared social beliefs and misconceptions that maintain stigmas about women’s health.
Stored with the screening record, where it is evidence for the labels above.
How this classification was reachedexpand
The three-model screen
all 5,600 screened works →All three models called this out of scope.
Literature review of social determinants of diagnostic delay in endometriosis; uses a review to answer a clinical-epidemiological question.
This reviews social determinants of delayed endometriosis diagnosis, not evidence-synthesis methodology.
Literature review of social factors delaying endometriosis diagnosis; clinical care pathways, not research systems.
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.044 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".