Experience with shared decision making in gynaecological practice: treatment decisions in patients with dysfunctional uterine blood loss.
SourceEuropean Journal of Obstetrics & Gynecology and Reproductive Biology, 120, 2, (2005), pp. 210-216
Article / Letter to editor
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Medical Technology Assessment
European Journal of Obstetrics & Gynecology and Reproductive Biology
SubjectDCN 1: Perception and Action; EBP 2: Effective Hospital Care; NCEBP 2: Evaluation of complex medical interventions; UMCN 3.3: Neurosensory disorders; UMCN 5.2: Endocrinology and reproduction
OBJECTIVE: To study the impact of introducing a blood loss chart as a means to support treatment selection in women with dysfunctional uterine blood loss. STUDY DESIGN: Retrospective chart review, prospective observational study, and decision modelling. RESULTS: Introduction of a blood loss chart resulted in a 50% reduction of re-treatments within 1 year (from 25% to 12.5%). The use of the blood loss chart resulted in a slightly higher expected value and lower costs, which is reflected in a more favourable cost/quality adjusted life year (QALY) ratio. CONCLUSION: The use of a blood loss chart as an aid in treatment selection in women with dysfunctional uterine blood loss is feasible. Although its use requires an extra outpatient visit, the associated extra costs are off-set by its impact on initial treatment selection, and, in particular, on the probability of re-treatment within 1 year of follow-up.
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