A Cost Utility Analysis of Sonograhestrography Compared with Hysteroscopic Evaluation for Dysfunctional Uterine Bleeding

Abstract

Research was conducted to discover whether the cost utility of sonohysterography was superior to hysteroscopic diagnosis for patients with dysfunctional uterine bleeding. Participants in: this study consisted of sonography patients (N = 100), who received care in a managed care setting. This correlational study covered, a 12-motnth period. Relative value units (RVU) were used from the same region to compare costs between treatments. Discounting was not done because these data were collected over the it same 1-year period. Thes time trade-off method was:Sused to obtain measures of preences for health states. Both treatment and control subjects rated their perceptions. Patients reported values an average of 0.67 (on a scale from 0 to 1 where perfect health was given a1). A chart review provided the ability to see a return to normal health. The change in health pecption rating was 0.30. Regionally, RVU csting was done and demonstrated that costs were $ 100 for sonohysterography and $217.00 forr, hysteroscope evaluation. Global cots as well as any patients' losses in revenue were considered. The rnimprvemen0t in health status was replicated and again demonstrated: worthiness of treating dysfunctional uterine bleding. Costs were compared, and it was shown that a cost saving exists for sonohysterography over hysteroscopic evaluation. For patients in this region, sonohysteroaphy had a better economic evalu4ation than hysteroscopic evaluation in treating this debilitating gynecologic condition.

Review of quality of life: menorrhagia in women with or without inherited bleeding disorders

“…The median score in the study group was two (range 0-19) and was worse than that in the control group (median 1, range 0-11) (P = 0.07). The number of women who reported limitation of physical role was significantly Coulter et al [12] Compare outcomes for those having surgery with those not having surgery Self-devised social impact scores and SF-36 (only effect sizes given) 4 Cooper et al [13] Compare medical and hysteroscopic management of heavy menstrual loss SF-36 5 Cooper et al [14] Compare microwave endometrial ablation and transcervical resection of the endometrium for treatment of heavy menstrual loss SF-36 6 Evans et al [15] To discover whether cost utility of sonohysterography was superior to hysteroscopic diagnosis for patients with DUB Self-rated health scale with 0 = death and 1.0 = normal health 7 Winkler et al [16] To assess whether tranexamic acid would increase QOL in women with heavy menstrual bleeding Self-devised five graded questions on a five point scale 8 Loffer et al [17] To compare uterine balloon therapy and hysteroscopic rollerball endometrial ablation in the treatment of menorrhagia To determine the effectiveness of endometrial cryoablation in comparison with rollerball electroablation Response to question Ôduring your last menstrual cycle, to what extent did excessive uterine bleeding affect your general quality of lifeÕ 13 Abbott et al [22] To compare two second generation endometrial ablation systems in women with dysfunctional uterine bleeding who want conservative surgical treatment Euro QOL-5D, SF-12 14 Abbott et al [23] To compare four methods of endometrial ablation with regard to outcomes Euro QOL-5D, SF-12 15 Hawe et al [24] To compare the effectiveness of the Cavaterm thermal balloon endometrial ablation system with Nd:YAG laser for the treatment of dysfunctional uterine bleeding EQ-5D, SF-12 16 Kadir et al [25] To assess the QOL during menstruation in women with inherited bleeding disorders in comparison with a control group Self-devised ÔQuality of life scoreÕ ranging from 10 (poor quality of life) to 60 (good quality of life) 17 Kouides et al [6] To assess quality of life during current menstruation in women with vWD compared to those in the general population…”

“…Fifty-three articles were identified as relevant. Eighteen studies [6,[10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] included a baseline questionnaire to assess quality of life in women with menorrhagia prior to treatment, were considered for further review. The details of these studies are given in Table 1.…”

“…The median score in the study group was two (range 0-19) and was worse than that in the control group (median 1, range 0-11) (P = 0.07). The number of women who reported limitation of physical role was significantly To determine the effectiveness of endometrial cryoablation in comparison with rollerball electroablation Response to question Ôduring your last menstrual cycle, to what extent did excessive uterine bleeding affect your general quality of lifeÕ 13 Abbott et al [22] To compare two second generation endometrial ablation systems in women with dysfunctional uterine bleeding who want conservative surgical treatment Euro QOL-5D, SF-12 14 Abbott et al [23] To compare four methods of endometrial ablation with regard to outcomes Euro QOL-5D, SF-12 15 Hawe et al [24] To compare the effectiveness of the Cavaterm thermal balloon endometrial ablation system with Nd:YAG laser for the treatment of dysfunctional uterine bleeding EQ-5D, SF-12 16 Kadir et al [25] To assess the QOL during menstruation in women with inherited bleeding disorders in comparison with a control group Self-devised ÔQuality of life scoreÕ ranging from 10 (poor quality of life) to 60 (good quality of life) 17 Kouides et al [6] To assess quality of life during current menstruation in women with vWD compared to those in the general population…”

Reporting and Analysis of Trial-Based Cost-Effectiveness Evaluations in Obstetrics and Gynaecology

“…Just over half of the studies were conducted in gynaecology (56%; n = 23). Most studies conducted a CEA (87%; n = 39), and five (11%) studies [ 46 , 49 , 52 , 69 , 77 ] conducted a CUA. One (2%) study [ 79 ] conducted both a CEA and a CUA.…”

“…One (2%) study [ 79 ] conducted both a CEA and a CUA. The hospital perspective was used in 28 (62%) studies [ 35 – 38 , 40 – 45 , 47 – 50 , 53 , 55 , 59 , 60 , 62 , 65 – 68 , 71 , 73 – 75 , 78 ], followed by the healthcare perspective (22%; n = 10) [ 39 , 46 , 51 , 52 , 54 , 58 , 63 , 69 , 70 , 77 ] and the societal perspective (12%; n = 5) [ 56 , 57 , 64 , 76 , 79 ]. In two (4%) studies [ 61 , 72 ], the perspective was unclear.…”