Validity of the screening for early endometriosis detection (SEED) screening tool: protocol for a cross-sectional study

INTRODUCTION: Endometriosis is a systemic inflammatory condition associated with chronic pelvic pain, delayed diagnosis and substantial impacts on physical and mental health. Many young adults (aged 18–25) experience symptoms for years before receiving a diagnosis, yet symptom-based screening tools have not been adequately validated for this population with respect to convergent, divergent and criterion validity. This protocol describes the validation of the Screening for Early Endometriosis Detection (SEED) measurement tool for young adults in Canada assigned female at birth with endometriosis or chronic pelvic pain. METHODS AND ANALYSIS: A total of 300 individuals assigned female at birth who have been diagnosed with endometriosis or chronic pelvic pain will be recruited to complete a questionnaire package assessing the SEED measurement tool alongside established measures of related and distinct constructs. Convergent validity will be evaluated by examining associations between SEED scores and measures expected to be related to endometriosis symptoms and their impacts while divergent validity will be assessed through associations with less closely related measures. Criterion validity, sensitivity and specificity will be evaluated by comparing SEED scores between participants with endometriosis and participants with chronic pelvic pain without endometriosis. Receiver operating characteristic curve analyses will assess the ability of the SEED to discriminate between groups and identify an appropriate screening cut-off, with sensitivity prioritised for early identification. ETHICS AND DISSEMINATION: The study has received approval from the Women’s College Hospital Research Ethics Board (REB #2024-0065-E). Participants will provide informed consent prior to participation. The study results will be disseminated through peer-reviewed journal publications, conference presentations and summaries for participants. Dissemination will be supported by a systematic knowledge translation approach, including work with key interest holders to identify implementation barriers and facilitators and an implementation toolkit to support the adoption of endometriosis screening for young adults.