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

2006; Elsevier BV; Volume: 194; Issue: 2 Linguagem: Inglês

10.1016/j.ajog.2005.08.014

1097-6868

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

Gynecological conditions and treatments

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