Does Probability Guided Hysteroscopy Reduce Costs in Women Investigated for Postmenopausal Bleeding?. (16th February 2015)

• Record Type: Journal Article
• Authors: 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.
• Other Names: Breuer Eun-Kyoung Academic Editor.
• Is Part Of: TheScientificWorldjournal. Volume 2015(2015)
• Publication Date: 2015-02-16
• Subjects: Science -- Periodicals; Technology -- Periodicals; Medicine -- Periodicals; 505
• DOI: 10.1155/2015/605312
• Languages: English
• ISSNs: 2356-6140

Abstract

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. 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.