Randomized trial of medical treatment versus hysterectomy for abnormal uterine bleeding: resource use in the Medicine or Surgery (Ms) trial.

作者信息

Showstack Jonathan, Lin Feng, Learman Lee A, Vittinghoff Eric, Kuppermann Miriam, Varner R Edward, Summitt Robert L, McNeeley S Gene, Richter Holly, Hulley Stephen, Washington A Eugene

机构信息

Department of Medicine, University of California, San Francisco, CA, USA.

出版信息

Am J Obstet Gynecol. 2006 Feb;194(2):332-8. doi: 10.1016/j.ajog.2005.08.014.

DOI:10.1016/j.ajog.2005.08.014

PMID:16458625

Abstract

OBJECTIVE

This study was undertaken to compare resource use outcomes for participants in the Medicine or Surgery (Ms) randomized trial.

STUDY DESIGN

In a randomized controlled trial, we compared resources used during a 24-month follow-up period by women with abnormal uterine bleeding who were randomly assigned to either expanded medical treatment or hysterectomy.

RESULTS

Women randomly assigned to hysterectomy used significantly more resources (medicine = $4479, hysterectomy = $6777; P = .03), with almost all the difference caused by the hysterectomy procedure. Fifty-three percent of women randomly assigned to medicine had a hysterectomy during the follow-up period; women who were able to continue on medical therapy had mean total resource use of $2595 compared with $6128 for medicine patients who eventually had surgery.

CONCLUSION

For women with abnormal uterine bleeding refractory to cyclic medroxyprogesterone acetate, compared with expanded medical treatment, hysterectomy increases resource use significantly and results in better clinical and 6-month quality-of-life outcomes.

摘要