Diagnosis of endometrial abnormality: comparison of outpatient procedures within cohorts defined by age and menopausal status
Critchley HOD, Warner P, Lee AJ, Brechin S, Guise J, Graham B
Record ID 32001000740
English
Authors' objectives:
To compare three outpatient methods of endometrial evaluation in terms of performance, patient acceptability and cost-effectiveness.
Authors' recommendations:
Decision-making about investigation would be clarified if postmenopausal women were studied separately from premenopausal women with menstrual bleeding problems. For postmenopausal women exclusion of cancer is a main objective, so once investigation has been completed discharge follows, but in the woman with abnormal menstrual bleeding, even if serious pathology is excluded, the original presenting symptoms require management. About 60% of premenopausal women with abnormal bleeding reported that their symptoms were not ‘much improved’ at 10 months. Research is needed to understand this phenomenon, and to explore ways to integrate patient factors into optimising evaluation and treatment. The significance of benign pathologies in this group also requires clarification. Given the relatively small differences observed in cost-effectiveness, there is justification for allowing other issues (such as clinician preferences and women’s perspectives) to influence decisions as to the investigation method. There is scope to make better use of patient factors to inform decisions as to the most efficient and acceptable method of investigation for an individual woman. Additional analyses, using data available as a result of this study, will contribute to this agenda.
Details
Project Status:
Completed
URL for project:
http://www.hta.ac.uk/1063
Year Published:
2004
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
England, United Kingdom
MeSH Terms
- Premenopause
- Postmenopause
- Menstruation Disturbances
- Menstruation
- Uterine Diseases
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:
2009 Queen's Printer and Controller of HMSO
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