Bipolar radio frequency endometrial ablation compared with balloon endometrial ablation in dysfunctional uterine bleeding: Impact on patients' health-related quality of life
ABSTRACT To compare health-related quality of life (HRQoL) after bipolar radio frequency ablation and thermal balloon ablation in women with dysfunctional uterine bleeding.
Randomized clinical trial.
Women suffering from dysfunctional uterine bleeding.
Bipolar radio frequency ablation and thermal balloon ablation.
Patients were asked to complete HRQoL questionnaires at baseline, and at 2 days, 2 weeks, 3 months, 6 months, and 12 months after surgery. The questionnaires contained the medical outcomes study Short-Form 36 (SF-36), the Self-rating Depression Scale, the Rotterdam Symptom Checklist, State-Trait Anxiety Inventory, and a structured clinical history questionnaire.
Data on HRQoL were available on at least two different time points in 115 of 126 randomized patients. HRQoL improved significantly over time in both groups, except for the domain of general health in the SF-36. None of the dimensions showed a significant difference between both groups, neither was there a significant interaction between time and treatment effect.
Both methods significantly improved HRQoL in women with dysfunctional uterine bleeding. However, despite better amenorrhea and satisfaction rates after bipolar radio frequency ablation, there was no difference in HRQoL between the two groups.
[Show abstract] [Hide abstract]
ABSTRACT: ‘Menorrhagia’, or heavy menstrual bleeding, is a common problem affecting women. The principal driver for treatment is women's experience of its interference in their lives, so a measure of quality of life (QoL) is increasingly used as the primary outcome to assess treatment success. QoL measures need to accurately reflect women's concerns as these measures are often used to inform resource allocation decisions within the healthcare service. Healthcare decision-makers often advocate the use of generic measures so as to achieve consistency when making decisions. Generic measures, by definition, have a broad focus on QoL in contrast to disease-specific measures that focus on dimensions of health relevant to the condition. We report a systematic review of studies that have either used or assessed economic outcome measures in menorrhagia, and present criteria for assessing which measure is the most appropriate. Studies including women presenting with menorrhagia, and using or assessing economic measures were sought by searching nine electronic databases. Fifty-six eligible studies were identified. A narrative synthesis was most suitable to the review question. Eleven studies assessed the psychometric properties of the outcome measures, twelve studies applied the measures in an economic evaluation, and thirty-three used them in effectiveness studies. Mixed results on the psychometric properties of the instruments were observed. Studies were often found to include both a disease-specific and a generic measure. We found no consensus on the most appropriate economic outcome measure to use when assessing the cost-effectiveness of treatment for menorrhagia. This is an important finding as QoL is the primary focus for treatment decisions. The cyclical nature of the condition has a large impact on the reliability and validity of outcome measurement. Alternative measures, such as willingness-to-pay, which embrace more than health and avoid standard recall periods should be explored.Social Science [?] Medicine 12/2013; 98:149–153. DOI:10.1016/j.socscimed.2013.09.016 · 2.56 Impact Factor
[Show abstract] [Hide abstract]
ABSTRACT: Key words: uterine bleeding, menorrhagia, metrorrhagia, pos partum hemorrhage.01/2007; 15(1):68-79.