Please use this identifier to cite or link to this item:
https://hdl.handle.net/2440/100870
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Type: | Journal article |
Title: | Does probability guided hysteroscopy reduce costs in women investigated for postmenopausal bleeding? |
Author: | Breijer, M. Van Hanegem, N. Visser, N. Verheijen, R. Mol, B. Pijnenborg, J. Opmeer, B. Timmermans, A. |
Citation: | The Scientific World Journal, 2015; 2015:605312-1-605312-5 |
Publisher: | Hindawi Publishing Corporation |
Issue Date: | 2015 |
ISSN: | 2356-6140 1537-744X |
Statement of Responsibility: | M. C. Breijer, N. van Hanegem, N. C. M. Visser, R. H. M. Verheijen, B. W. J. Mol, J. M. A. Pijnenborg, B. C. Opmeer, and A. Timmermans |
Abstract: | 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.Model based cost-minimization analysis.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.Costs for the different strategies.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.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. |
Keywords: | Endometrium Endometrial neoplasms Uterine hemorrhage Diagnostic errors Hysteroscopy Postmenopause Decision support techniques Costs and cost analysis |
Rights: | Copyright © 2015 M. C. Breijer et al. 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. |
DOI: | 10.1155/2015/605312 |
Published version: | http://dx.doi.org/10.1155/2015/605312 |
Appears in Collections: | Aurora harvest 7 Medicine publications |
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hdl_100870.pdf | Published version | 1.37 MB | Adobe PDF | View/Open |
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