Investigating postmenopausal bleeding for endometrial cancer: cost-effectiveness of initial diagnostic strategies

BJOG : an International Journal of Obstetrics and Gynaecology
T J ClarkK S Khan

Abstract

To determine the most cost-effective outpatient testing strategy for diagnosing endometrial cancer in women with postmenopausal bleeding (PMB). Decision analysis modelling. Women with postmenopausal bleeding. A decision analytic model was constructed to reflect current service provision, which evaluated 12 diagnostic strategies using endometrial biopsy (EB), ultrasonography (USS) (4- and 5-mm endometrial thickness cutoff) and hysteroscopy. Diagnostic probability estimates were derived from systematic quantitative reviews, clinical outcomes from published literature and cost estimates from local and NHS sources. The cost per additional life year gained (pound/LYG) was determined and compared for each diagnostic strategy, and sensitivity analyses were performed. Compared with carrying out no initial investigation, a strategy based on initial diagnosis with USS using a 5-mm cutoff was the least expensive (11,470 pound/LYG). Initial investigation with EB or USS using a 4-mm cutoff was comparably cost-effective (less than 30,000 pound/LYG versus USS with a 5-mm cutoff) at their most favourable diagnostic performance and at disease prevalence of 10% or more. The strategies involving initial evaluation with test combinations or hyster...Continue Reading

References

Mar 20, 1991·Journal of the National Cancer Institute·E Gurpide
Mar 1, 1988·British Journal of Cancer·J L Haybittle, E M Kingsley-Pillers
Aug 1, 1985·American Journal of Obstetrics and Gynecology·P A WingoH B Peterson
Jan 1, 1982·American Journal of Obstetrics and Gynecology·D A Grimes
Dec 21, 1994·Journal of the National Cancer Institute·K J Helzlsouer, T Bush
Oct 23, 1996·JAMA : the Journal of the American Medical Association·J E SiegelM R Gold
Nov 1, 1996·The Journal of the American Association of Gynecologic Laparoscopists·D Hidlebaugh
Jan 1, 1997·Irish Journal of Medical Science·S OngJ Murphy
Nov 25, 1997·American Journal of Obstetrics and Gynecology·A M WeberM R Piedmonte
Aug 8, 1998·BMJ : British Medical Journal·R J LilfordJ Chard
Nov 11, 1998·JAMA : the Journal of the American Medical Association·R Smith-BindmanD Grady
May 14, 1999·BMJ : British Medical Journal·S PalmerJ Raftery
Jul 31, 1999·British Journal of Obstetrics and Gynaecology·C P Spencer, M I Whitehead
Oct 3, 1999·BMJ : British Medical Journal·D J Torgerson, J Raftery
Jan 21, 2000·BMJ : British Medical Journal·A Briggs, A Gray
Apr 25, 2000·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·C C Bennett, D S Richards
Jun 14, 2000·BMJ : British Medical Journal·J Raftery
Aug 25, 2001·Lancet·G ElwynD Rovner
Sep 18, 2001·Drugs·B M Southcott
Oct 5, 2001·Lancet·M I Meltzer
Oct 23, 2001·International Journal of Cancer. Journal International Du Cancer·D M ParkinP Pisani
Feb 5, 2002·Clinical Oncology : a Journal of the Royal College of Radiologists·D HayneP Babb
Apr 13, 2002·BJOG : an International Journal of Obstetrics and Gynaecology·T Justin ClarkJanesh K Gupta
Jun 8, 2002·Obstetrics and Gynecology·T Justin ClarkKhalid S Khan
Sep 13, 2002·Acta Obstetricia Et Gynecologica Scandinavica·Janesh K GuptaKhalid S Khan
Sep 28, 2002·JAMA : the Journal of the American Medical Association·T Justin ClarkKhalid S Khan

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Citations

Dec 26, 2007·Pathology Oncology Research : POR·Zoltan MagyarZoltan Papp
Sep 9, 2008·Ultrasound Quarterly·Manjiri DigheTheodore Dubinsky
Dec 2, 2006·Obstetrics and Gynecology·John Collins
Feb 24, 2011·Obstetrics and Gynecology·Catherine M LeclairAlison B Edelman
Jan 19, 2010·Menopause : the Journal of the North American Menopause Society·Ettore CicinelliAchiropita Lepera
Mar 25, 2015·BJOG : an International Journal of Obstetrics and Gynaecology·A S-W WongD S Sahota
Jan 10, 2016·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Nehalennia van HanegemAnne Timmermans
Apr 17, 2012·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Maria C BreijerBrent C Opmeer
Nov 15, 2011·Best Practice & Research. Clinical Obstetrics & Gynaecology·Thierry Van den BoschFrederic Amant
Jul 15, 2015·Taiwanese Journal of Obstetrics & Gynecology·Ari KimHeung Yeol Kim
Nov 19, 2010·Gynecologic Oncology·Juan Luis Alcázar, Matías Jurado
Jul 24, 2010·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Ayman A A Ewies, Patrick Musonda
Jul 7, 2009·Best Practice & Research. Clinical Obstetrics & Gynaecology·Tommaso BignardiGeorge Condous
Jun 23, 2007·Best Practice & Research. Clinical Obstetrics & Gynaecology·Nadia C Samuel, T Justin Clark
Jul 5, 2015·Journal of Minimally Invasive Gynecology·Margit DueholmGitte Ørtoft
Jan 15, 2008·BJOG : an International Journal of Obstetrics and Gynaecology·F Alfhaily, A A A Ewies
Mar 27, 2012·Acta Obstetricia Et Gynecologica Scandinavica·Nikolaos BurbosTimothy J Duncan
Jul 3, 2013·Acta Obstetricia Et Gynecologica Scandinavica·Nicole C M VisserJohanna M A Pijnenborg
Aug 6, 2013·The Australian & New Zealand Journal of Obstetrics & Gynaecology·Mehmet C SalmanKunter Yuce
Sep 25, 2015·The Journal of Family Planning and Reproductive Health Care·Natalie A M CooperT Justin Clark
May 28, 2014·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·Margit DueholmGitte Ortoft
Apr 12, 2016·Journal of Women's Health·Abimbola O FamuyideShannon K Laughlin-Tommaso
Aug 5, 2015·Health Technology Assessment : HTA·T Justin ClarkJane P Daniels
Apr 3, 2013·American Journal of Obstetrics and Gynecology·Alexandra M McPencowXiao Xu
Apr 22, 2009·American Journal of Obstetrics and Gynecology·Laura J HavrileskyEvan R Myers
Dec 24, 2014·Menopause : the Journal of the North American Menopause Society·Margit DueholmGitte Ørtoft
Jul 28, 2007·Orvosi hetilap·Zoltán MagyarZoltán Papp
Feb 20, 2010·Obstetrics and Gynecology International·M C BreijerB C Opmeer
Dec 22, 2014·European Journal of Obstetrics, Gynecology, and Reproductive Biology·S SeshadriY Khalaf
Apr 1, 2014·Journal of Minimally Invasive Gynecology·Paul P SmithT Justin Clark
May 10, 2018·Climacteric : the Journal of the International Menopause Society·A GhoubaraA A A Ewies
Jan 9, 2010·Briefings in Bioinformatics·Daniël B van SchalkwijkAlbert A de Graaf
Jul 4, 2009·International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society·Fadi Alfhaily, Ayman A A Ewies
May 15, 2020·Minerva ginecologica·Marwa M AllamMohamed K Mehasseb
Apr 3, 2020·Climacteric : the Journal of the International Menopause Society·J Carugno

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