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Does Probability Guided Hysteroscopy Reduce Costs in Women Investigated for Postmenopausal Bleeding?
Objective. To evaluate whether a model to predict a failed endometrial biopsy in women with postmenopausal bleeding (PMB) and a thickened endometrium can reduce costs without compromising diagnostic accuracy. Design, Setting, and Population. Model based cost-minimization analysis. Methods. A decisio...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi Publishing Corporation
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4345274/ https://www.ncbi.nlm.nih.gov/pubmed/25785283 http://dx.doi.org/10.1155/2015/605312 |
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author | Breijer, M. C. van Hanegem, N. Visser, N. C. M. Verheijen, R. H. M. Mol, B. W. J. Pijnenborg, J. M. A. Opmeer, B. C. Timmermans, A. |
author_facet | Breijer, M. C. van Hanegem, N. Visser, N. C. M. Verheijen, R. H. M. Mol, B. W. J. Pijnenborg, J. M. A. Opmeer, B. C. Timmermans, A. |
author_sort | Breijer, M. C. |
collection | PubMed |
description | Objective. To evaluate whether a model to predict a failed endometrial biopsy in women with postmenopausal bleeding (PMB) and a thickened endometrium can reduce costs without compromising diagnostic accuracy. Design, Setting, and Population. Model based cost-minimization analysis. Methods. A decision analytic model was designed to compare two diagnostic strategies for women with PMB: (I) attempting office endometrial biopsy and performing outpatient hysteroscopy after failed biopsy and (II) predicted probability of a failed endometrial biopsy based on patient characteristics to guide the decision for endometrial biopsy or immediate hysteroscopy. Robustness of assumptions regarding costs was evaluated in sensitivity analyses. Main Outcome Measures. Costs for the different strategies. Results. At different cut-offs for the predicted probability of failure of an endometrial biopsy, strategy I was generally less expensive than strategy II. The costs for strategy I were always € 460; the costs for strategy II varied between € 457 and € 475. At a 65% cut-off, a possible saving of € 3 per woman could be achieved. Conclusions. Individualizing the decision to perform an endometrial biopsy or immediate hysteroscopy in women presenting with postmenopausal bleeding based on patient characteristics does not increase the efficiency of the diagnostic work-up. |
format | Online Article Text |
id | pubmed-4345274 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Hindawi Publishing Corporation |
record_format | MEDLINE/PubMed |
spelling | pubmed-43452742015-03-17 Does Probability Guided Hysteroscopy Reduce Costs in Women Investigated for Postmenopausal Bleeding? Breijer, M. C. van Hanegem, N. Visser, N. C. M. Verheijen, R. H. M. Mol, B. W. J. Pijnenborg, J. M. A. Opmeer, B. C. Timmermans, A. ScientificWorldJournal Research Article Objective. To evaluate whether a model to predict a failed endometrial biopsy in women with postmenopausal bleeding (PMB) and a thickened endometrium can reduce costs without compromising diagnostic accuracy. Design, Setting, and Population. Model based cost-minimization analysis. Methods. A decision analytic model was designed to compare two diagnostic strategies for women with PMB: (I) attempting office endometrial biopsy and performing outpatient hysteroscopy after failed biopsy and (II) predicted probability of a failed endometrial biopsy based on patient characteristics to guide the decision for endometrial biopsy or immediate hysteroscopy. Robustness of assumptions regarding costs was evaluated in sensitivity analyses. Main Outcome Measures. Costs for the different strategies. Results. At different cut-offs for the predicted probability of failure of an endometrial biopsy, strategy I was generally less expensive than strategy II. The costs for strategy I were always € 460; the costs for strategy II varied between € 457 and € 475. At a 65% cut-off, a possible saving of € 3 per woman could be achieved. Conclusions. Individualizing the decision to perform an endometrial biopsy or immediate hysteroscopy in women presenting with postmenopausal bleeding based on patient characteristics does not increase the efficiency of the diagnostic work-up. Hindawi Publishing Corporation 2015 2015-02-16 /pmc/articles/PMC4345274/ /pubmed/25785283 http://dx.doi.org/10.1155/2015/605312 Text en Copyright © 2015 M. C. Breijer et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Breijer, M. C. van Hanegem, N. Visser, N. C. M. Verheijen, R. H. M. Mol, B. W. J. Pijnenborg, J. M. A. Opmeer, B. C. Timmermans, A. Does Probability Guided Hysteroscopy Reduce Costs in Women Investigated for Postmenopausal Bleeding? |
title | Does Probability Guided Hysteroscopy Reduce Costs in Women Investigated for Postmenopausal Bleeding? |
title_full | Does Probability Guided Hysteroscopy Reduce Costs in Women Investigated for Postmenopausal Bleeding? |
title_fullStr | Does Probability Guided Hysteroscopy Reduce Costs in Women Investigated for Postmenopausal Bleeding? |
title_full_unstemmed | Does Probability Guided Hysteroscopy Reduce Costs in Women Investigated for Postmenopausal Bleeding? |
title_short | Does Probability Guided Hysteroscopy Reduce Costs in Women Investigated for Postmenopausal Bleeding? |
title_sort | does probability guided hysteroscopy reduce costs in women investigated for postmenopausal bleeding? |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4345274/ https://www.ncbi.nlm.nih.gov/pubmed/25785283 http://dx.doi.org/10.1155/2015/605312 |
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