Document Detail


Cost-utility of routine endometrial evaluation before le fort colpocleisis.
MedLine Citation:
PMID:  24763159     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
INTRODUCTION: Routine preoperative evaluation of the endometrium before Le Fort colpocleisis is often recommended. There are no data, however, to support this practice. In select patients, it may not be a necessary addition to the preoperative evaluation of Le Fort colpocleisis.
METHODS: A decision analysis model was created to compare uterine evaluation, by either endometrial (EM) biopsy or transvaginal ultrasound, to no evaluation for a hypothetical cohort of women undergoing Le Fort colpocleisis. We assumed the absence of risk factors for EM cancer. Probabilities and health outcome utilities were obtained from literature review. Medicare charges were used to estimate cost in 2012 US dollars. Cost-utility analysis was performed using US recommendations from a health plan perspective.
RESULTS: At willingness-to-pay thresholds of $50,000 and $100,000, no evaluation is superior to both biopsy and ultrasound. At a 64% probability of cancer, biopsy is more cost-effective than no evaluation and ultrasound.
CONCLUSIONS: Compared to biopsy and ultrasound, in low-risk women, no EM evaluation before Le Fort colpocleisis demonstrates superior cost-utility.
Authors:
Padma Kandadai; Michael Flynn; Susan Zweizig; Danielle Patterson
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Female pelvic medicine & reconstructive surgery     Volume:  20     ISSN:  2154-4212     ISO Abbreviation:  Female Pelvic Med Reconstr Surg     Publication Date:    2014 May-Jun
Date Detail:
Created Date:  2014-04-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101528690     Medline TA:  Female Pelvic Med Reconstr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  168-73     Citation Subset:  IM    
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