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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...

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Autores principales: 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.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2015
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.
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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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