A comparison of the cost–utility of ultrasound‐guided high‐intensity focused ultrasound and hysterectomy for adenomyosis: a retrospective study

Xf, Liu; Lh, Huang; Zhang, C; Huang, GH; Yan, LM; He, Jia

doi:10.1111/1471-0528.14746

Cited by 17 publications

(30 citation statements)

References 22 publications

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“…We included 38 trials, reporting on data from 5175 women ( Table I ) ( Fedele et al , 1997 ; Maia et al , 2003 ; Hadisaputra and Anggraeni, 2006 ; Bragheto et al , 2007 ; Kim et al , 2007 ; Cho et al , 2008 ; Kang et al , 2009 ; Sheng et al , 2009 ; Kang et al , 2010 ; Ozdegirmenci et al , 2011 ; Zhou et al , 2011 ; Kelekci et al , 2012 ; Ekin et al , 2013 ; Liu et al , 2014 ; Zhang et al , 2014 ; Huang et al , 2015 ; Lee et al , 2015 , 2019 ; Long et al , 2015 ; Chong et al , 2016 ; Liu et al , 2016 ; Park et al , 2016 ; Hai et al , 2017 ; Huang et al , 2017 ; Liu et al , 2017 ; Osuga et al , 2017 ; Yang et al , 2017 , 2019 ; Alizzi, 2018 ; Guo et al , 2018 ; Jun-Min et al , 2018 ; Li et al , 2018 , 2020 ; Huang et al , 2020 ; Lin et al , 2020 ; Sun et al , 2020 ; Kwack et al , 2021 ; Sun et al , 2021 ). There were six (16%) randomized controlled trials (RCTs) ( Hadisaputra and Anggraeni, 2006 ; Kang et al , 2010 ; Ozdegirmenci et al , 2011 ; Zhang ...…”

Section: Resultsmentioning

confidence: 99%

“…There were six (16%) randomized controlled trials (RCTs) ( Hadisaputra and Anggraeni, 2006 ; Kang et al , 2010 ; Ozdegirmenci et al , 2011 ; Zhang et al , 2014 ; Osuga et al , 2017 ; Lin et al , 2020 ); 13 studies (34%) were prospective, non-randomized trials, of which nine had cohorts with a single arm ( Fedele et al , 1997 ; Bragheto et al , 2007 ; Kim et al , 2007 ; Cho et al , 2008 ; Sheng et al , 2009 ; Zhou et al , 2011 ; Ekin et al , 2013 ; Alizzi, 2018 ; Yang et al , 2019 ) and four studies had two or more arms ( Kelekci et al , 2012 ; Huang et al , 2015 ; Yang et al , 2017 ; Li et al , 2018 ). There were 17 (45%) retrospective cohort studies, 12 with a single arm ( Kang et al , 2009 ; Liu et al , 2014 , 2016 ; Lee et al , 2015 , 2019 ; Long et al , 2015 ; Chong et al , 2016 ; Park et al , 2016 ; Hai et al , 2017 ; Huang et al , 2017 ; Jun-Min et al , 2018 ; Kwack et al , 2021 ) and five with two or more arms ( Maia et al , 2003 ; Liu et al , 2017 ; Guo et al , 2018 ; Huang et al , 2020 ; Li et al , 2020 ). Two studies with a single cohort did not specify if the cohort was retrospective or prospective ( Sun et al , 2020 , 2021 ).…”

Section: Resultsmentioning

confidence: 99%

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A systematic review of outcome reporting and outcome measures in studies investigating uterine-sparing treatment for adenomyosis

Tellum

Omtvedt

Naftalin

et al. 2021

Human Reproduction Open

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STUDY QUESTION Which outcomes and outcome measures are reported in interventional trials evaluating the treatment of adenomyosis? SUMMARY ANSWER We identified 38 studies, reporting on 203 outcomes using 133 outcome measures. WHAT IS KNOWN ALREADY Heterogeneity in outcome evaluation and reporting has been demonstrated for several gynaecological conditions and in fertility studies. In adenomyosis, previous systematic reviews have failed to perform a quantitative analysis for central outcomes, due to variations in outcome reporting and measuring. STUDY DESIGN, SIZE, DURATION A systematic search of Embase, Medline and Cochrane Register of Controlled Trials (CENTRAL) was performed with a timeframe from 1950 until February 2021, following the preferred reporting items for systematic reviews and meta-analysis (PRISMA). PARTICIPANTS/MATERIALS, SETTING, METHODS Studies reporting on any uterus-sparing intervention to treat adenomyosis, both prospective and retrospective, were eligible for inclusion. Inclusion criteria were a clear definition of diagnostic criteria for adenomyosis and the modality used to make the diagnosis, a clear description of the intervention, a follow up time of ≥ 6 months, a study population of n ≥ 20, a follow up rate of at least 80%, and English language. The population included premenopausal women with adenomyosis. Risk of bias was assessed using the Evidence Project risk of bias tool. MAIN RESULTS AND THE ROLE OF CHANCE We included 38 studies (6 randomized controlled trials and 32 cohort studies), including 5175 participants with adenomyosis. The studies described 10 interventions and reported on 203 outcomes, including 43 classified as harms, in 29 predefined domains. Dysmenorrhea (reported in 82%), heavy menstrual bleeding (HMB) (in 79%) and uterine volume (in 71%) were the most common outcomes. Fourteen different outcome measures were used for dysmenorrhea and 17 for HMB. Quality of life was reported in 9 (24%) studies, patient satisfaction with treatment in 1 (3%). A clear primary outcome was stated in only 18%. LIMITATIONS, REASONS FOR CAUTION This review includes studies with a high risk of bias. WIDER IMPLICATIONS OF THE FINDINGS Shortcomings in the definition and choice of outcomes and outcome measures limit the value of the conducted research. The development and implementation of a core outcome set (COS) for interventional studies in adenomyosis could improve research quality. This review suggests a lack of patient centred research in adenomyosis and people with adenomyosis should be involved in the development and implementation of the COS. STUDY FUNDING/COMPETING INTEREST(S) No funds specifically for this work was received. TT receives fees from General Electrics for lectures on ultrasound independently of this project. TRIAL REGISTRATION NUMBER This review is registered with the International Prospective Register of Systematic Reviews (PROSPERO; registration number CRD42020177466) and the Core Outcome Measures in Effectiveness Trials (COMET) initiative (registration number 1649).

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

A systematic review of outcome reporting and outcome measures in studies investigating uterine-sparing treatment for adenomyosis

Tellum

Omtvedt

Naftalin

et al. 2021

Human Reproduction Open

View full text Add to dashboard Cite

show abstract

“…The incidence of minor adverse events was 39.0%, 51.3% and 3.6% after HIFU, PMWA and RFA, respectively. The main minor adverse events were transient sciatic nerve pain, transient unilateral leg weakness, transient hematuria, skin burn, vaginal bleeding and lower abdominal pain in the HIFU group [19][20][21]24,26,28,[35][36][37], and transient macroscopic hematuria, vaginal discharge and lower abdominal pain in the PMWA and RFA groups [46][47][48]51,52,54]. Although all cases were minor and recovered without any permanent adverse effects, these events revealed thermal injury to the surrounding tissues, such as the sciatic nerve, bladder, endometrium, bowel and abdominal skin.…”

Section: Main Findings and Comparison With Existing Literaturementioning

confidence: 99%

Image-guided thermal ablation in the management of symptomatic adenomyosis: a systematic review and meta-analysis

Liu

Wang

Lei

2021

International Journal of Hyperthermia

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Objective: To evaluate the clinical effects of image-guided thermal ablation for the treatment of symptomatic adenomyosis (AD). Data sources: We searched PubMed, Web of Science, Cochrane Library, EMBASE, ClinicalTrials.gov and Google Scholar for literature from January 2000 to September 2020. Methods of study selection: We included all studies reporting clinical outcomes of image-guided thermal ablation for AD, involving high-intensity focused ultrasound (HIFU), percutaneous microwave ablation (PMWA) and radiofrequency ablation (RFA). Two independent researchers performed study selection according to the screening criteria. Results: A total of 38 studies representing 15,908 women were included. Compared with those at baseline, the visual analog scale scores, the symptom severity scores and the menorrhagia severity scores decreased significantly after these thermal ablation therapies. The mean ablation time was 92.18 min, 24.15 min and 31.93 min during HIFU, PMWA and RFA, respectively. The non-perfused volume ratio of AD was 68.3% for HIFU, 82.5% for PMWA and 79.2% for RFA. The reduction rates of uterine volume were 33.6% (HIFU), 46.8% (PMWA) and 44.0% (RFA). The reduction rates of AD volume were 45.1% (HIFU), 74.9% (PMWA) and 61.3% (RFA). The relief rates of dysmenorrhea were 84.2% (HIFU), 89.7% (PMWA) and 89.2% (RFA). The incidence of minor adverse events was 39.0% (HIFU), 51.3% (PMWA) and 3.6% (RFA). The re-intervention rates were 4.0% (HIFU) and 28.7% (RFA). The recurrence rate was 10.2% after HIFU. The pregnancy rates were 16.7% (HIFU), 4.93% (PMWA) and 35.8% (RFA). Conclusion: Image-guided HIFU, PMWA and RFA may be effective and safe minimally invasive therapies for symptomatic AD.

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“…Although HIFU has been used widely in China for the treatment of adenomyosis, , the clinical application of this treatment modality in most other countries is still considered novel. We believe that reporting on a case with a complication is important for enhancing experience.…”

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confidence: 99%

Thermal bowel injury after ultrasound‐guided high‐intensity focused ultrasound treatment of uterine adenomyosis

Seto

Cheung

2018

Ultrasound in Obstet & Gyne

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A comparison of the cost–utility of ultrasound‐guided high‐intensity focused ultrasound and hysterectomy for adenomyosis: a retrospective study

Abstract: USgHIFU can safely be used to treat patients with adenomyosis and significantly improved the quality of life of patients after treatment. The cost of USgHIFU is less than that of surgical treatment.

Cited by 17 publications

References 22 publications

A systematic review of outcome reporting and outcome measures in studies investigating uterine-sparing treatment for adenomyosis

A systematic review of outcome reporting and outcome measures in studies investigating uterine-sparing treatment for adenomyosis

Image-guided thermal ablation in the management of symptomatic adenomyosis: a systematic review and meta-analysis

Thermal bowel injury after ultrasound‐guided high‐intensity focused ultrasound treatment of uterine adenomyosis

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