"SO FAR AWAY" How Doctors Can Contribute to Making Endometriosis Hell on Earth. A Call for Humanistic Medicine and Empathetic Practice for Genuine Person-Centered Care. A Narrative Review

Impact of Therapeutic Interventions on Fear of Progression in Patients with Endometriosis

Background/Objectives: Endometriosis is a chronic disease associated with pain, infertility, and increased risk of mental disorders (anxiety, depression). One of these manifestations is the fear of progression, recently documented in patients with endometriosis, which can affect their quality of life. Our study aims to evaluate the relationship between the fear of progression and the type of treatment in endometriosis. Methods: We conducted a prospective survey of 298 patients with endometriosis, divided into four treatment groups (hormonal therapy without or with surgical indication, surgical intervention, phytotherapy). Fear of progression (FoP) was evaluated through the Fear of Progression Questionnaire-Short Form (FoP-Q-SF). Scores were compared between groups using the Kruskal-Wallis test with Dunn's post hoc analysis and adjusted for age (ANCOVA). Results: FoP was generally high. Significant differences between groups were observed (p = 0.021), with the highest FoP-Q-SF scores being in patients undergoing exclusive hormonal treatment, higher than in the surgical groups (p < 0.01). Younger age correlated with increased fear (p < 0.01). Conclusions: Treatment type influences anxiety regarding disease progression. Exclusive hormonal therapy was associated with the greatest fear of progression, while the differences observed between hormonal therapy with surgical indication and primary surgical treatment may partly be due to methodological or informational factors rather than purely clinical differences. A multidisciplinary approach, including psychological support, is essential to alleviate patient fears and improve their quality of life.

Polarization in research: What is it, why is it problematic, and how can it be addressed?

Background: Polarized research has become a problem for the trustworthiness and applicability of scientific results. Accordingly, this paper addresses three key questions: 1) What is polarization in scientific research? 2) Why is such polarization problematic? 3) How can the problem be addressed?Methods: The first question is addressed by describing how the polarization has been characterized in the literature and by analysing an example before assessing existing definitions and elaborating a definition of polarization. The second question is answered by describing challenges with polarization found in the literature. The third question is addressed by investigating different explanations for and relevant mechanisms behind polarization in research, such as psychological, structural, epistemic and ontological, evaluative, and social-constructionist explanations. Moreover, several approaches from the philosophy of science are investigated.Results: Polarization in research is characterized by opposing and incommensurable positions that tend to stem from differences in basic values, and that are used to define, differentiate, bolster, and demarcate between groups and for reinforcing their identity. The problem with polarization is that it violates a broad range of basic norms in science, and hampers scientific progress, represents large opportunity costs, undermines trust in science and, subsequently that it undercuts the application of scientific results as well as future funding. There are many potential measures to reduce polarization. However, there are no simple solutions, as polarization is a complex phenomenon deeply rooted in basic human characteristics.Conclusion: Polarization is a ubiquitous phenomenon and a basic challenge for scientific research. It is crucial to increase the awareness of polarization, and a clear definition is key to study and address the problem. However, while there are many ways to actively address the problem of polarization in scientific research, there are no easy solutions. More research is needed to move from what we can do to what we should do.

Artificial Intelligence in the Management of Women with Endometriosis and Adenomyosis: Can Machines Ever Be Worse Than Humans?

Artificial intelligence (AI) is experiencing advances and integration in all medical specializations, and this creates excitement but also concerns. This narrative review aims to critically assess the state of the art of AI in the field of endometriosis and adenomyosis. By enabling automation, AI may speed up some routine tasks, decreasing gynecologists' risk of burnout, as well as enabling them to spend more time interacting with their patients, increasing their efficiency and patients' perception of being taken care of. Surgery may also benefit from AI, especially through its integration with robotic surgery systems. This may improve the detection of anatomical structures and enhance surgical outcomes by combining intra-operative findings with pre-operative imaging. Not only that, but AI promises to improve the quality of care by facilitating clinical research. Through the introduction of decision-support tools, it can enhance diagnostic assessment; it can also predict treatment effectiveness and side effects, as well as reproductive prognosis and cancer risk. However, concerns exist regarding the fact that good quality data used in tool development and compliance with data sharing guidelines are crucial. Also, professionals are worried AI may render certain specialists obsolete. This said, AI is more likely to become a well-liked team member rather than a usurper.