A Novel Classification of Endometriosis Based on Clusters of Comorbidities
Sarria-Santamera A. Yemenkhan Y. Terzic M. Ortega M.A. Asunsolo del Barco A.
September 2023Multidisciplinary Digital Publishing Institute (MDPI)
Biomedicines
2023#11Issue 9
Endometriosis is a heterogeneous, complex, and still challenging disease, due to its epidemiological, etiological and pathogenic, diagnostic, therapeutic, and prognosis characteristics. The classification of endometriosis is contentious, and existing therapies show significant variability in their effectiveness. This study aims to capture and describe clusters of women with endometriosis based on their comorbidity. With data extracted from electronic records of primary care, this study performs a hierarchical clustering with the Ward method of women with endometriosis with a subsequent analysis of the distribution of comorbidities. Data were available for 4055 women with endometriosis, and six clusters of women were identified: cluster 1 (less comorbidity), cluster 2 (anxiety and musculoskeletal disorders), cluster 3 (type 1 allergy or immediate hypersensitivity); cluster 4 (multiple morbidities); cluster 5 (anemia and infertility); and cluster 6 (headache and migraine). Clustering aggregates similar units into similar clusters, partitioning dissimilar objects into other clusters at a progressively finer granularity—in this case, groups of women with similarities in their comorbidities. Clusters may provide a deeper insight into the multidimensionality of endometriosis and may represent diverse “endometriosis trajectories” which may be associated with specific molecular and biochemical mechanisms. Comorbidity-based clusters may be important to the scientific study of endometriosis, contributing to the clarification of its clinical complexity and variability. An awareness of those comorbidities may help elucidate the etiopathogenesis and facilitate the accurate earlier diagnosis and initiation of treatments targeted toward particular subgroups.
adults , cluster analysis , endometriosis , female
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Department of Biomedical Sciences, Nazarbayev University School of Medicine, Astana, 010000, Kazakhstan
Department of Medicine, Nazarbayev University School of Medicine, Astana, 010000, Kazakhstan
Department of Surgery, Nazarbayev University School of Medicine, Astana, 010000, Kazakhstan
Clinical Academic Department of Women’s Health, National Research Center for Maternal and Child Health, University Medical Center, Astana, 010000, Kazakhstan
Department of Obstetrics, Gynecology and Reproductive Sciences, School of Medicine, University of Pittsburgh, Pittsburgh, 15213, PA, United States
Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, 28801, Spain
Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, 28034, Spain
Cancer Registry and Pathology Department, Hospital Universitario Principe de Asturias, Alcalá de Henares, 28805, Spain
Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcala, Alcalá de Henares, 28801, Spain
Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, 10017, NY, United States
Department of Biomedical Sciences
Department of Medicine
Department of Surgery
Clinical Academic Department of Women’s Health
Department of Obstetrics
Department of Medicine and Medical Specialties
Ramón y Cajal Institute of Sanitary Research (IRYCIS)
Cancer Registry and Pathology Department
Department of Surgery
Department of Epidemiology and Biostatistics
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