Diagnostic discrepancies and clinical value of second medical opinions (SMO) for endometriosis: a nationwide study analysis

BMC Womens Health. 2025 Dec 15;25(1):595. doi: 10.1186/s12905-025-04052-z.

Abstract

Objectives: The aim of this study is to evaluate the second medical opinions (SMOs) clinical value for endometriosis diagnostic strategy and patient profiles, using nationwide data from a specialized French physician network dedicated to SMOs and endometriosis management.

Methods & materials: We conducted an observational cohort study including patients from France who submitted a request for an SMO through a dedicated platform (https://www.deuxiemeavis.fr/) between January 1st, 2020, and March 31st, 2024. Patients completed predefined questionnaires and subsequently received a written report following the expert SMO.

Results: A total of 3,061 patients requested a SMO for endometriosis. Most patients (61.1%) declared experiencing chronic painful symptoms a negative impact on daily life, corresponding to an Eastern Cooperative Oncology Group (ECOG) score ≥ 1. Dysmenorrhea was reported by 50.7% of patients, and 69.4% reported interruption of intercourse due to pain. Among the 2,987 patients with a complete medical record, the SMO modified the diagnosis in 51.1% of cases. After SMO, experts were unable to establish a conclusion in only 5.0% of cases, compared to 24.7% after the first medical opinion. For patients finally diagnosed with endometriosis, the SMO provided a diagnosis at a mean of 3.8 ± 1.5 years after symptom onset.

Conclusion: Seeking a SMO with access to medical experts can be essential for patients dealing with painful symptoms unsuccessfully treated, or other problems such as endometriosis diagnosis.

Supplementary Information: The online version contains supplementary material available at 10.1186/s12905-025-04052-z.

Keywords: Endometriosis; Endometriosis diagnosis; Second medical opinion.