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https://hdl.handle.net/2440/84740
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dc.contributor.author | Breijer, M. | - |
dc.contributor.author | van Doorn, H. | - |
dc.contributor.author | Clark, T. | - |
dc.contributor.author | Khan, K. | - |
dc.contributor.author | Timmermans, A. | - |
dc.contributor.author | Mol, B. | - |
dc.contributor.author | Opmeer, B. | - |
dc.date.issued | 2012 | - |
dc.identifier.citation | European Journal of Obstetrics Gynecology and Reproductive Biology, 2012; 163(1):91-96 | - |
dc.identifier.issn | 0301-2115 | - |
dc.identifier.issn | 1872-7654 | - |
dc.identifier.uri | http://hdl.handle.net/2440/84740 | - |
dc.description.abstract | <h4>Objective</h4>To evaluate the cost-effectiveness of diagnostic strategies incorporating the diagnostic value of patient characteristics for endometrial carcinoma using prediction models.<h4>Study design</h4>A decision analytic model was created to compare four diagnostic strategies for women with postmenopausal bleeding: the main outcome measures were 5 year survival, costs, and cost-effectiveness of three model based strategies compared to the strategy reflecting current practice.<h4>Results</h4>A strategy selecting women for endometrial biopsy based on their history only, dominated all other strategies (more effective, less cost). In a clinical scenario where transvaginal sonography (TVS) was assumed to be an integral part of the consultation without additional costs, a strategy selecting high-risk women for TVS became the most cost-effective strategy.<h4>Conclusions</h4>Strategies taking into account the individual probability based on a prognostic model are less costly than the currently applied strategy for a similar effectiveness. The most cost-effective strategy depends on the clinical setting: in areas where TVS is performed by the consulting gynecologist without extra costs, selective TVS based on history is the most cost-effective strategy. When TVS is not readily available and therefore incurs extra costs, a risk selection based on patient characteristics is most cost-effective. | - |
dc.description.statementofresponsibility | Maria C. Breijer, Helena C. Van Doorn, T. Justin Clark, Khalid S. Khan, Anne Timmermans, Ben W.J. Mol, Brent C. Opmeer | - |
dc.language.iso | en | - |
dc.publisher | Elsevier Ireland | - |
dc.rights | Copyright © 2012 Elsevier Ireland Ltd. All rights reserved. | - |
dc.source.uri | http://dx.doi.org/10.1016/j.ejogrb.2012.03.025 | - |
dc.subject | Cost-effectiveness; Decision analysis; Endometrial carcinoma; Postmenopausal bleeding | - |
dc.title | Diagnostic strategies for endometrial cancer in women with postmenopausal bleeding: cost-effectiveness of individualized strategies | - |
dc.type | Journal article | - |
dc.identifier.doi | 10.1016/j.ejogrb.2012.03.025 | - |
pubs.publication-status | Published | - |
dc.identifier.orcid | Mol, B. [0000-0001-6887-0262] [0000-0001-8337-550X] | - |
Appears in Collections: | Aurora harvest 7 Obstetrics and Gynaecology publications |
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