Hysterectomy, endometrial ablation and Mirena® for heavy menstrual bleeding: a systematic review of clinical effectiveness and cost-effectiveness analysis
| Autor: | S, Bhattacharya, L J, Middleton, A, Tsourapas, A J, Lee, R, Champaneria, J P, Daniels, T, Roberts, N H, Hilken, P, Barton, R, Gray, K S, Khan, P, Chien, P, O'Donovan, K G, Cooper, J, Abbott, J, Barrington, M Y, Bongers, J-L, Brun, R, Busfield, T J, Clark, J, Cooper, S L, Corson, K, Dickersin, N, Dwyer, M, Gannon, J, Hawe, R, Hurskainen, W R, Meyer, H, O'Connor, S, Pinion, A M, Sambrook, W H, Tam, I A A, van Zon-Rabelink, E, Zupi |
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| Rok vydání: | 2011 |
| Předmět: |
medicine.medical_specialty
lcsh:Medical technology Cost effectiveness medicine.medical_treatment Cost-Benefit Analysis Population Urinary incontinence Levonorgestrel Hysterectomy Time Postoperative Complications Contraceptive Agents Female Medicine Humans education Menorrhagia Endometrial Ablation Techniques education.field_of_study business.industry Health Policy Endometrial cancer Hazard ratio Retrospective cohort study medicine.disease Surgery Treatment Outcome lcsh:R855-855.5 Patient Satisfaction Endometrial ablation Female Quality-Adjusted Life Years medicine.symptom business Research Article |
| Zdroj: | Health Technology Assessment, Vol 15, Iss 19 (2011) |
| ISSN: | 2046-4924 |
| Popis: | Objective The aim of this project was to determine the clinical effectiveness and cost-effectiveness of hysterectomy, first- and second-generation endometrial ablation (EA), and Mirena® (Bayer Healthcare Pharmaceuticals, Pittsburgh, PA, USA) for the treatment of heavy menstrual bleeding. Design Individual patient data (IPD) meta-analysis of existing randomised controlled trials to determine the short- to medium-term effects of hysterectomy, EA and Mirena. A population-based retrospective cohort study based on record linkage to investigate the long-term effects of ablative techniques and hysterectomy in terms of failure rates and complications. Cost-effectiveness analysis of hysterectomy versus first- and second-generation ablative techniques and Mirena. Setting Data from women treated for heavy menstrual bleeding were obtained from national and international trials. Scottish national data were obtained from the Scottish Information Services Division. Participants Women who were undergoing treatment for heavy menstrual bleeding were included. Interventions Hysterectomy, first- and second-generation EA, and Mirena. Main outcome measures Satisfaction, recurrence of symptoms, further surgery and costs. Results Data from randomised trials indicated that at 12 months more women were dissatisfied with first-generation EA than hysterectomy [odds ratio (OR): 2.46, 95% confidence interval (CI) 1.54 to 3.93; p = 0.0002), but hospital stay [WMD (weighted mean difference) 3.0 days, 95% CI 2.9 to 3.1 days; p |
| Databáze: | OpenAIRE |
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