Discussion Questions

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  What was the study objective?

  
  
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  Can you summarize the study design?

  
  
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  Who comprised the study population?

  
  
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  Can you describe the statistical methodology?

  
  
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  What are the advantages and limitations of the validation strategy?

  
  
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  How do these findings affect individual patient management?

  
  
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  How do risk-assessment models improve patient care?

  
  
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  What are the strengths and weaknesses of this study?

Hysterectomy is one of the most common surgeries among women in the United States. Most procedures are performed for benign indications, such as abnormal uterine bleeding due to endometrial or myometrial pathology, bulk-related symptoms caused by leiomyomas, and chronic pelvic pain. Despite increasing interest in minimally invasive modalities employing new technologies, most hysterectomies are performed either transabdominally (about 60% of cases) or vaginally (about 30% of cases). Vaginal hysterectomy has been associated with a shorter stay and faster recovery than occurs with abdominal surgery; when performed by experienced surgeons, the methods have comparable complication rates.

The success of the National Surgical Quality Improvement Program in reducing morbidity and mortality in surgery has triggered widespread interest in applying similar quality improvement systems to other practice areas. These depend on reliable metrics—measures of performance—for assessment of risk-adjusted outcomes after frequently performed procedures.