Clinical Evaluation Methods Research Articles

Colon Target Drug Delivery System Review

For the local treatment of a number of bowel disorders such as ulcerative colitis, Crohn's disease, amoebiasis and sand, colonic cancer, the local treatment of colonic pathologies, and the systemic distribution of protein and peptide medicines, targeted drug delivery into the colon is extremely desirable. A medication must be properly formulated for colon-focused drug delivery. To ensure sudden or controlled release in the proximal colon, the substance must first be shielded from degradation, release, and absorption in the upper GI tract. The advantages and disadvantages, cutting-edge methods for colon-targeted drug delivery, clinical evaluation methods, and some details about commercial dosage forms are the main topics of this paper

Non-melanoma skin cancer of the head and neck.

Skin cancer is the most common malignancy in the world, and the majority of cases affect the skin of the head and neck. The face is a particularly emotive area for patients who often present with a lesion that is causing them concern. This article reviews the identification, diagnosis and principles of management of non-melanoma skin cancer of the head and neck. There are many lesions of the skin which are benign and mimic skin cancer. The differential of head and neck skin lesions and how to determine their nature is discussed. The vast majority of non-melanoma skin cancer are basal cell carcinoma, followed by squamous cell carcinoma. These and the other types of non-melanoma skin cancer are described and illustrated. Current methods of clinical identification, diagnosis and evaluation of skin cancers are clarified, and contemporary treatment paradigms are presented.

Evolution of China regulatory guidance on the clinical evaluation of medical devices and its implication on pre-market and post-approval clinical evaluation strategies

ABSTRACT Introduction The rapid growth of the medical device industry has driven the evolution of regulatory guidance on medical device clinical evaluation (MDCE) of the China National Medical Products Administration (NMPA), which consequently influences pre–market and post–approval clinical evaluation (CE) strategies. Areas covered We aimed to investigate the 3–stage evolution of NMPA regulatory guidance on MDCE (1. The era before specific CE guidance, 2. 2015 CE Guidance, and 3. 2021 CE Guidance Series), analyze the gaps between each stage, and assess the evolution’s impact on pre–market and post–approval CE strategies. Expert opinion The fundamental principles of the NMPA 2021 CE Guidance Series were transformed from the 2019 International Medical Device Regulatory Forum documents. Compared with the 2015 guidance, the 2021 CE Guidance Series further clarifies the CE definition by emphasizing the ongoing activity of CE through an entire product lifecycle and the use of scientifically sound methods for CE and narrows the pre–market CE pathways into the equivalent device and clinical trial pathways. The 2021 CE Guidance Series simplifies the process for selecting the pre–market CE strategy but does not specify post–approval CE update cadency and general requirements for post-market clinical follow–up.

Clinimetric methods for evaluating patients with Parkinson's disease in the context of the latest treatment strategies

Background: Parkinson's disease is a neurodegenerative disease involving the deposition of alpha-synuclein deposits in dopaminergic neurons of the black matter, resulting in a decrease in dopamine levels in the central nervous system and the development of motor and non-motor symptoms. Aim of the study: This study aims to identify clinimetric methods for evaluating patients with Parkinson's disease in the context of contemporary therapies. Material and methods: English-language scientific literature from 2012 - 2022 from databases such as PubMed, SCOPUS, Web of Science, Google Scholar was reviewed. Searches were conducted according to keywords: Parkinson's disease, clinical evaluation, and treatment methods. 69 items of literature were qualified for analysis. Results and conclusions: The diagnosis of Parkinson's disease is a diagnosis by exclusion, there are no available and inexpensive methods to diagnose the disease with certainty. The clinimetric assessment of the patient is therefore the basis not only for diagnosis but also for effective, tailored treatment. There are many assessment tools dedicated to patients with this disease entity, and these are the ones recommended for this process. Contemporary treatment methods, especially for those in whom the effectiveness of pharmacological treatment is unsatisfactory, include deep brain stimulation, enteral infusion of DuoDopa®, and subcutaneous infusion/injections of apomorphine. The inclusion of the techniques depends mainly on the assessed condition of the patient.

Minimally invasive K-wire fixation of displaced intraarticular calcaneal fractures through a minimal sinus tarsi approach

BackgroundDisplaced intra-articular calcaneal fractures are challenging injuries, and there is debate regarding the best method of treatment.Patients and methodsBetween January 2018 and January 2021, a prospective study was conducted on 46 patients with 56 displaced intraarticular calcaneal fractures that were treated with minimally invasive fixation using Kirschner wires (KWs) through the sinus tarsi approach.ResultsThe mean follow-up period was 22.36 months. The American Orthopaedic Foot and Ankle Society (AOFAS) score was adopted as a method of clinical evaluation; the mean AOFAS score was 78.4. All cases showed radiographic evidence of adequate healing, with no collapse till the final follow-up. Complications included persistent pain, subtalar arthritis, deep infection and superficial pin site infection.ConclusionThe use of the sinus tarsi approach and percutaneous KWs represents a minimally invasive approach which expands the indications of surgery for displaced intra-articular calcaneal fractures with fewer treatment-related complications.Level of evidence (4) case series.Trial registration This study has been approved by the ethical research committee of the Faculty of Medicine, Tanta University, under the code: 35901/10/22.

THE ANALYTICAL STUDY OF “ROLE OF VARIOUS ETIOLOGICAL FACTORS FOR THE PRECIPITATION OF ACUTE SEIZURES

Background: Seizures are a result of shift in the normal balance of excitation and inhibition within the central nervous system. Acute symptomatic seizures are those caused or provoked by acute medical or neurological illness Aims And Objectives: 1.To study the etiological spectrum of acute symptomatic seizures. 2. To evaluate new onset seizures by clinical and appropriate laboratory and radiological evaluation Methods: 170 patients attending the outpatient department and emergency department with diagnosis of acute seizures in Department of Medicine and allied specialties in KIMS &RF hospital from SEPTEMBER 2020 to OCTOBER 2022 are selected for the study Results: In this study ASS was seen more in males (60%) than females (40%).GTCS was seen in 75.2% subjects, 21.1% subjects presented with focal seizures and 3.52% subjects had focal seizures with secondary generalisation. Metabolic insults were found in 25.9% subjects ,Vascular insults 15.9% , Drug withdrawal seizures 15.9%, adult onset seizures 5%, Primary generalized epilepsy 8.8%, Cerebral Venous Sinus thrombosis 7.6%, Alcohol withdrawal in 4.1%,trauma 5.3%, neurocysticercosis 2.4%,tuberculoma 2.9%,drug poisoning 1.2% Conclusion: Incidence of ASS was more during early adulthood and middle aged persons. Metabolic insults accounted for a large portion (25.9%) ,vascular insults (15.9%), drug withdrawal seizures(15.9%), seizures secondary to CVT (7.6%), trauma(5.3%), alcohol withdrawal(4.1%), NCC (2.4%), tuberculoma (2.9%).Acute symptomatic seizures continue to be a useful concept for classication and prognosis

Clinical Teacher Evaluation Methods in Medical Education: A Systematic Review

Context: Evaluating systems is one of the essential items affecting faculty member performance. Using an appropriate evaluating system is essential for performing different proper roles for faculty members. Objective: This study aimed to systematically review the models, tools, and challenges of evaluating the performance of clinical faculty members. Methods: This systematic review investigated eight international and four national electronic databases in 2019. Descriptive and thematic analyses were done to extract the most relevant information about the models, tools, and challenges of evaluating the performance of clinical faculty members. Results: In total, 15163 articles were identified, of which 25 met the inclusion criteria. The findings were demonstrated in four main categories of the model of evaluating the performance of clinical faculty members, education, data gathering tools, and challenges of evaluating the performance of clinical faculty members. The main subthemes for evaluating the performance of the clinical faculty member model were systems, structure, indicators, and process. Conclusions: This study recommends policymakers and educational managers to design an appropriate evaluating tool. Further research should be conducted to develop a practical system for solving the mentioned challenges.

Preliminary Evaluation of Hemodynamic Effects of Fontan Palliation on Renal Artery Using Computational Fluid Dynamics

Background: The assessment of renal function is important to the prognosis of patients needing Fontan palliation due to the reconstructed compromised circulation. To know the relationship between the kidney perfusion and hemodynamic characteristics during surgical design could reduce the risk of acute kidney injury (AKI) and the postoperative complications. However, the issue is still unsolved because the current clinical evaluation methods are unable to predict the hemodynamic changes in renal artery (RA). Methods: We reconstructed a three-dimensional (3D) vascular model of a patient requiring Fontan palliation. The technique of computational fluid dynamics (CFD) was utilized to explore the changes of RA hemodynamics under different possible blood flow rates. The relationship between the kidney perfusion and hemodynamic characteristics was investigated. Results: The calculated results indicated the declined tendency of the pressure and pressure drop as the flow rate decreased. When the flow rate decreased to two-thirds of its baseline, both the pressure of left renal artery (LRA) and the pressure of right renal artery (RRA) dipped below 50%, and the pressure of RRA fell more quickly than that of LRA. Uneven distribution of WSS was observed on the trunk of RA, and the lowest WSS was found at the distal of RA. The average WSS in RA dropped to around 50% as the flow rate reached one-third of its baseline. Conclusions: As a promising approach, CFD can be utilized to quantitatively evaluate the hemodynamic characteristics of RA and contribute to offsetting the drawbacks of clinical assessments of renal function, to help realize better prognosis for the patients with Fontan palliation.

Clinical Evaluation Methods for Limited Episiotomy

Epizyotomi, zor doğumları kolaylaştırmak ve doğum kanalını genişletmek için perinede bulunan bulbokavernos kasa yapılan cerrahi kesi işlemidir. Epizyotominin rutin olarak yapılmaması gerektiği konusunda artık evrensel bir fikir birliği bulunmaktadır. ACOG, epizyotominin gerekli olduğu belirli bir durum olmadığını, epizyotomi kararı klinik değerlendirme yapılması gerektiğini belirtmektedir. Bu nedenle epizyotomi uygulama kararı alınırken objektif yöntemlerin kullanılması gerekliliği kaçınılmazdır. Araştırmalara göre doku elastikiyetesinin, kas uzayabilirliğinin, perineal vücut uzunluğunun değerlendirilmesi yöntemleri kullanılabilmektedir. Tüm kadınların özellikle üçüncü trimesterde pelvik taban kaslarının viskoelastik özelliklerinin değerlendirilmesi önerilmektedir. Bu şekilde doğum şekli ve önleyici stratejilerin uygulanmasında bireyselleştirilmiş bakım sunulabilecektir. Ayrıca bu değerlendirme sayesinde mediolateral epizyotomi uygulamasına ilişkin nasıl yapıldığı ve doğumdan sonra yapılması gereken bakımlara ilişkin bilgilendirme yapılabileceği belirtilmektedir. Bu tür bir doğum öncesi bilgi, müdahalenin daha iyi kabul edilmesine ve doğum sırasındaki acil durum bilgisine kıyasla gerçek bir bilgilendirilmiş onam alınmasına imkânı sunmaktadır.

Long-Term Results of Gamma Knife Radiosurgery for Trigeminal Neuralgia

Although the short- to medium-term efficacy of Gamma Knife therapy for drug-resistant essential trigeminal neuralgia has been reported, long-term evaluations are limited. We evaluated patient data obtained at least 10years post-treatment and examined the significance of this treatment using new end points. Among 249 consecutive patients with essential trigeminal neuralgia who were treated with Gamma Knife radiosurgery (retrogasserian target/4-mm single isocenter/90Gy at 100%) at our institution between January 2003 and October 2011, 103 patients who were followed up for at least 10years (mean, 174 [120-219] months) after treatment and whose data were amenable to accurate evaluation, were included in this retrospective study. Herein, we used the Barrow Neurological Institute (BNI) pain intensity scale as a clinical evaluation method for pain and the BNI numbness scale to evaluate complications (namely facial dysesthesia). The initial and final follow-up pain attack cessation (BNI pain intensity score I-IIIa) rate was 82.5% (85 of 103) and 58.2% (60 of 103), respectively. Furthermore, sensory impairment (BNI numbness score≥II) at the last follow-up was observed in 24.3% (25 of 103) of the cases, while very bothersome status (BNI numbness score IV) was observed in 2.9% of the cases. Gamma Knife radiosurgery for essential trigeminal neuralgia showed good therapeutic effects during long-term follow-up. Serious complications of significant concern in the short- to mid-term follow-up, resolved spontaneously. Therefore, the indications for treatment should be expanded to include patients who strongly desire Gamma Knife therapy.

Gastric sensorimotor function and its clinical measurement.

Gastroduodenal symptoms are highly prevalent, with underlying sensorimotor dysfunction contributing in many patients. Common symptoms include early satiation, postprandial fullness, epigastric bloating, pain or burning, nausea and vomiting, which collectively affect over 7% of adults. However, the clinical evaluation of these symptoms remains challenging, with current tests of gastric function remaining limited in their ability or availability to separate specific patient subgroups or guide-targeted care. In the current edition of Neurogastroenterology & Motility, Silver et al. present new data showing correlations between patterns of intragastric meal distribution and symptom profiles in a large series of patients undergoing gastric emptying scintigraphy. Studies of this type are important, as they motivate understanding beyond existing disease labels, and orient focus toward deeper mechanistic profiling. This brief review provides an overview of gastric sensorimotor function and profiles several current and emerging methods of clinical evaluation. Perspectives are provided on accommodation testing, gastric emptying, measuring gastric myoelectrical activity including new approaches, and antroduodenal manometry. Although gastric physiology is complex, recent progress has been encouraging, with the heterogenous pathophysiology of gastric symptoms continuing to be unraveled, and new techniques for evaluating gastric function and symptoms emerging. Ongoing progress will now depend on continuing to accurately profile the underlying mechanisms of gastroduodenal disorders to identify specific disease phenotypes that inform care.

Methods for Clinical Evaluation of Artificial Intelligence Algorithms for Medical Diagnosis.

Adequate clinical evaluation of artificial intelligence (AI) algorithms before adoption in practice is critical. Clinical evaluation aims to confirm acceptable AI performance through adequate external testing and confirm the benefits of AI-assisted care compared with conventional care through appropriately designed and conducted studies, for which prospective studies are desirable. This article explains some of the fundamental methodological points that should be considered when designing and appraising the clinical evaluation of AI algorithms for medical diagnosis. The specific topics addressed include the following: (a) the importance of external testing of AI algorithms and strategies for conducting the external testing effectively, (b) the various metrics and graphical methods for evaluating the AI performance as well as essential methodological points to note in using and interpreting them, (c) paired study designs primarily for comparative performance evaluation of conventional and AI-assisted diagnoses, (d) parallel study designs primarily for evaluating the effect of AI intervention with an emphasis on randomized clinical trials, and (e) up-to-date guidelines for reporting clinical studies on AI, with an emphasis on guidelines registered in the EQUATOR Network library. Sound methodological knowledge of these topics will aid the design, execution, reporting, and appraisal of clinical evaluation of AI.

Approach to advanced practice nursing student clinical during COVID-19.

Approach to advanced practice nursing student clinical during COVID-19.

A mouse model of allergic conjunctivitis permitting tear eosinophil quantification

IntroductionAllergic conjunctivitis is an immune-mediated inflammatory disease of the conjunctiva that is induced by antigens. Allergic conjunctivitis can cause various symptoms such as ocular itching, hyperemia and edema. Developing experimental animal models that show clinical symptoms and methods for quantitative and objective evaluation is important for understanding allergic conjunctivitis. Therefore, this study aimed to develop an ovalbumin (OVA)-induced mouse model of allergic conjunctivitis and a useful method for evaluating symptoms of allergic conjunctivitis. MethodsICR mice were sensitized by an intraperitoneal injection of OVA in PBS containing alum on days 0 and 5. Subsequently, local sensitization was then performed once daily from days 14 to 28, by instilling OVA in PBS into the both eyes. Drug treatment was administered once daily from days 14 to 28. Mice were randomly assigned topical treatment groups: Group 1, 0.1% betamethasone; Group 2, 0.025% levocabastine; Group 3 PBS (control). ResultsMice showed marked eye scratching behavior, hyperemia, edema, infiltration of eosinophils into tears and increased antigen-specific immunoglobulin E antibody levels in tears and the serum. These symptoms were inhibited by instillation of levocabastine and betamethasone, which are used clinically for the treatment of allergic conjunctivitis. DiscussionThis method may be useful for evaluation of the symptoms of allergic conjunctivitis in experimental and clinical settings. In particular, the developed method, which measures the number of eosinophils in tears collected with phenol red threads, may enable the quantitative, objective, and noninvasive evaluation of the severity of allergic conjunctivitis.

Health science students’ perceptions about Objective Structured Clinical Examination (OSCE) as a method of clinical evaluation

Background: For decades, practical clinical examinations have been valid and reliable methods to evaluate health sciences undergraduate students’ clinical performance and competencies for a wide range of skills. Objective structured clinical examination (OSCE) is a widely used practical clinical examination. This study aims to assess health sciences students’ perceptions about OSCE as an evaluation method of clinical skills acquisition. Methods: A descriptive cross-sectional design was used, and 157 students of five health science programs, who undergo real-time OSCE at Prince Sultan Military College of Health Sciences (PSMCHS), Dhahran, were invited to participate in this study. Data were collected through a structured questionnaire and analyzed quantitatively. Results: The findings revealed that 57.8% of the participants perceived OSCE positively due to its unique features related to structure, logical sequence, standardized score tools, and coverage of a broad spectrum of critical clinical skills. On the contrary, 62.3% (n=96) of participants believed OSCE was stressful, and 58.4% (n=90) thought it was threatening because of inadequate preparation. Conclusion: Health sciences students perceived OSCE as an effective evaluation method for clinical skills. However, OSCEs generate feelings of uncertainty and aggravate a high-stress level. This stress requires the educators at the academic and clinical settings to conduct dry run simulated scenarios beforehand to orient and guide students to manage and confound their stress and anxiety during real-life OSCE experiences.

The correlation between multimodal radiomics and pathology about thermal ablation lesion of rabbit lung VX2 tumor.

ObjectiveTo explore the correlation of CT-MRI pathology with lung tumor ablation lesions by comparing CT, MRI, and pathological performance of rabbit lung VX2 tumor after thermal ablation.MethodsThermal ablation including microwave ablation (MWA) and radiofrequency ablation (RFA) was carried out in 12 experimental rabbits with lung VX2 tumors under CT guidance. CT and MRI performance was observed immediately after ablation, and then the rabbits were killed and pathologically examined. The maximum diameter of tumors on CT before ablation, the central hypointense area on T2-weighted image (T2WI) after ablation, and the central hyperintense area on T1-weighted image (T1WI) after ablation and pathological necrosis were measured. Simultaneously, the maximum diameter of ground-glass opacity (GGO) around the lesion on CT after ablation, the surrounding hyperintense area on T2WI after ablation, the surrounding isointense area on T1WI after ablation, and the pathological ablation area were measured, and then the results were compared and analyzed.ResultsAblation zones showed GGO surrounding the original lesion on CT, with a central hypointense and peripheral hyperintense zone on T2WI as well as a central hyperintense and peripheral isointense zone on T1WI. There was statistical significance in the comparison of the maximum diameter of the tumor before ablation with a central hyperintense zone on T1WI after ablation and pathological necrosis. There was also statistical significance in the comparison of the maximum diameter of GGO around the lesion on CT with the surrounding hyperintense zone on T2WI and isointense on T1WI after ablation and pathological ablation zone. There was only one residual tumor abutting the vessel in the RFA group.ConclusionsMRI manifestations of thermal ablation of VX2 tumors in rabbit lungs have certain characteristics with a strong pathological association. CT combined with MRI multimodal radiomics is expected to provide an effective new method for clinical evaluation of the immediate efficacy of thermal ablation of lung tumors.

OSCE as summative evaluation for neurological examination: Perception of nursing students

Introduction: OSCE is a method of practical examination and a tool for evaluation. Instead of patients, topics and materials are used. It serves as a multidimensional practical test of clinical abilities as well as a tool for determining scientific competence Situation in the medical field. Aim of this study to assess the perception of nursing students on OSCE as a Summative method of evaluation regarding neurological examination among students pursuing nursing education at district Sirmour, Himachal Pradesh. Methods: A cross sectional descriptive survey design was adopted for the study to determine the effectiveness of OSCE in appraisal of clinical skills in Neurological examination among III year B.Sc. Nursing students. A convenience sampling technique was used to select 49 members, after obtaining consent OSCE was conducted with 5 stations to assess the clinical competencies necessary to perform the Neurological Examination and Perception of OSCE was assessed using the 5 point Likert Scale questionnaire.Results: The study result showed that highest percentage of students 42 students (85.7%) has their preference of examination as traditional method and only 7 (14.3%) of students preferred OSCE as a type of evaluation for examination. The overall perception shows that majority of students (55.1%) had negative perception about OSCE and 42.9% had neutral perception towards OSCE method of evaluation. Conclusion: Implementation of OSCE along with traditional method of clinical evaluation may enhance practice and enable the students to provide quality care by following principles and steps of procedure. Quality of learning can be enhanced by stressing more on OSCE method of assessment both as a formative and summative evaluation in nursing curriculum.

Real-World Evidence of Traditional Chinese Medicine (TCM) Treatment on Cancer: A Literature-Based Review.

While randomized controlled trials (RCTs) are the gold standard for evidence-based medicine, they do not always reflect the real condition of patients in the real-world setting, which limits their generalizability and external validity. Real-world evidence (RWE), generated during routine clinical practice, is increasingly important in determining external effectiveness of the tightly controlled conditions of RCTs and is well recognized as a valuable complement to RCTs by regulatory bodies currently. Since it could provide new ideas and methods for clinical efficacy and safety evaluation of traditional Chinese medicine (TCM) and high-quality evidence support, real-world study (RWS) has received great attention in the field of medicine, especially in the field of TCM. RWS has shown desirable adaptability in the clinical diagnosis and treatment practice of traditional Chinese medicine. Consequently, it is increasingly essential for physicians and researchers to understand how RWE can be used alongside clinical trial data on TCM. Here, we discuss what real-world study is and outline the benefits and limitations of real-world study. Furthermore, using examples from TCM treatment on cancer, including Chinese herbal medicine, acupuncture, moxibustion, integrated TCM and Western medicine treatment, and other treatments, we elaborate how RWE can be used to help inform treatment decisions when doctoring patients with cancer in the clinic.

A New Immersive Virtual Reality Station for Cardiopulmonary Resuscitation Objective Structured Clinical Exam Evaluation.

The Objective Structured Clinical Exam (OSCE) is an assessment tool used as a reliable method for clinical competence evaluation of students. This paper presents an investigation focused on the chain of survival, its related exploration, management, and technical skills, and how Virtual Reality (VR) can be used for the creation of immersive environments capable of evaluating students’ performance while applying the correct protocols. In particular, the Cardiopulmonary Resuscitation (CPR) procedure is studied as an essential step in the development of the chain of survival. The paper also aims to highlight the limitations of traditional methods using mechanical mannequins and the benefits of the new approaches that involve the students in virtual, immersive, and dynamic environments. Furthermore, an immersive VR station is presented as a new technique for assessing CPR performance through objective data collection and posterior evaluation. A usability test was carried out with 33 clinicians and OSCE evaluators to test the viability of the presented scenario, reproducing conditions of a real examination. Results suggest that the environment is intuitive, quick, and easy to learn and could be used in clinical practice to improve CPR performance and OSCE evaluation.

A clinical scoring system for the diagnosis of adenomyosis

Objective:To develop a scoring system using clinical evaluation methods to predict the presence of adenomyosis.Materials and Methods:A cohort of 232 patients who underwent hysterectomy for benign gynecologic disorders was prospectively enrolled. A detailed anamnesis was obtained and physical/pelvic examinations with trans-vaginal ultrasound imaging were performed one day before the hysterectomy. The diagnosis of adenomyosis was based on histopathologic examination. Findings were compared between patients with (n=55) and without (n=166) adenomyosis. Factors associated with adenomyosis were assessed with regression analysis and odds ratios (OR) were calculated. The variables found to be significant were chosen for the scoring system. Receiver operating characteristic analysis was carried out to find the cut-off values for these variables.Results:Number of parity, dyspareunia and dysmenorrhea visual analogue scale (VAS) scores, age of menarche, presence of uterine tenderness and detection of heterogeneous myometrium and myometrial cysts during ultrasonography were found to be the significant parameters. OR for the presence of myometrial heterogeneity, myometrial cysts, uterine tenderness were 27.2, 3.6 and 9.3 respectively. Cut-off values were calculated; 3 for parity (OR=2.8), 13-years for menarche (OR=1.6), 2 for dyspareunia VAS scores (OR=1.9) and 4 for dysmenorrhea VAS scores (OR=1.2). The total sum of maximum OR that a patient can obtain was calculated as 47.6 and this value was assumed to predict the presence of adenomyosis 100%. The multiplication of the sum of the OR in a patient by 2.1 (100/47.2) was found to have a predictive ability for the presence of adenomyosis.Conclusion:A scoring system is developed to predict adenomyosis non-invasively based on clinical evaluation.