Deep dyspareunia and central sensitization in endometriosis: A prospective study with online daily pain diary
Bibliographic record
Abstract
Objective A role for central sensitization has been suggested for endometriosis-associated deep dyspareunia. We explored the relationship between prospective deep dyspareunia scores with pain-pressure threshold (PPT) and bladder/pelvic floor tenderness (BPFT). Material and methods Observational prospective study from January 2017–April 2019 at a tertiary center for endometriosis. Inclusion criteria: 18–49 years; diagnosed endometriosis; new or re-referred to the center and consented to the center’s data registry [cases]. People without endometriosis were also recruited [controls]. Extra-pelvic PPT was measured at bilateral deltoids and first-dorsal interosseous (FDI) muscles on the test day. After the test day, case participants prospectively completed a daily pain diary over six weeks, with the deep dyspareunia severity (0–10) at each episode of sexual intercourse. Results 36 people with endometriosis and 19 controls were included. No significant differences in extra-pelvic PPT were found between controls and cases. Among people with endometriosis, PPT trended lower in people with higher deep dyspareunia on the prospective daily diaries, although not significantly different. In contrast, BPFT (present/absent) was significantly associated with higher deep dyspareunia on the prospective daily diaries (5.90 ± 2.77 vs 3.65 ± 2.39, p = .029). Conclusion In patients with endometriosis, prospective daily diaries of deep dyspareunia were not associated with extra-pelvic PPT but were associated with BPFT.
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How this classification was reachedexpand
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 | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".