Cost-effectiveness of diagnostic strategies for the management of abnormal uterine bleeding (heavy menstrual bleeding and post-menopausal bleeding): Systematic reviews, IPD meta-analysis and model based economic evaluation

Cooper NA, Barton PM, Breijer M, Caffrey O, Opmeer BC, Timmermans A, Mol BW, Khan KS, Clark TJ
Record ID 32011000650
English
Authors' objectives:

To determine the accuracy and cost-effectiveness of various tests and test combinations for the investigation of heavy menstrual bleeding and postmenopausal bleeding

Authors' recommendations: For initial investigation of women presenting to secondary care with HMB who do not require preservation of their fertility, our research suggests a choice between OPH alone or a combination of OPH and EBx. From our investigation, OPH appears to be the optimal first-line diagnostic test used for the investigation of women presenting to secondary care with HMB wishing to preserve their fertility or refractory to previous medical treatment with the LNG-IUS. We would suggest that the current recommendation of basing the initial investigation of women with PMB on the universal TVS measurement of endometrial thickness at a 5-mm threshold may need to be replaced by a strategy of restricting TVS to women with risk factors (e.g. increasing age-raised body mass index, diabetes or nulliparity), obtained from the preceding clinical assessment.
Details
Project Status: Completed
Year Published: 2014
URL for published report: http://www.journalslibrary.nihr.ac.uk/hta/hta18240/#/abstract
URL for additional information: http://www.journalslibrary.nihr.ac.uk/hta/volume-18/issue-24#hometab4
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: England, United Kingdom
MeSH Terms
  • Cost-Benefit Analysis
  • Menorrhagia
  • Postmenopause
  • Uterine Hemorrhage
Contact
Organisation Name: NIHR Health Technology Assessment programme
Contact Address: NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK
Contact Name: journals.library@nihr.ac.uk
Contact Email: journals.library@nihr.ac.uk
Copyright: <p>2014 Queen's Printer and Controller of HMSO</p>
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.