The article below summarizes a roundtable discussion of a study published in this issue of the Journal in light of its methodology, relevance to practice, and implications for future research. Article discussed:
Kopeika J, Edmonds SE, Mehra G, et al. Does hydrothermal ablation avoid hysterectomy? Long-term follow-up. Am J Obstet Gynecol 2011;204:207.e1-8.
The full discussion appears at www.AJOG.org , pages e1-2.
Discussion Questions
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What kind of information can we get from a case series?
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What were the immediate results of surgery?
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How was the survey process accomplished?
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What were the strengths and weaknesses of this study?
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What is comparative effectiveness?
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What are the challenges of this type of research?
Menorrhagia is quite common and places a major burden on women. World Health Organization data from developing countries indicate that 8-27% of women endure heavy menstrual bleeding. In the Western world, at least 22% of general gynecologic referrals for secondary care are for menstrual disorders. Hysterectomy remains the gold-standard treatment, but surgery can be associated with significant morbidity. This reality, combined with the high percentage of patients, spurred the development of less invasive options over the past 15-20 years. But how do these treatments compare to one another, and do they remain effective over time? The data are limited. For this reason, Journal club participants agreed that a new study by Kopeika and colleagues was an important addition to the literature. The researchers examined the safety and efficacy of hydrothermal ablation, as well as patients’ long-term satisfaction with the results.
See related article, page 207
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