Page 139 - The diagnostic work-up of women with postmenopausal bleeding

Table 2. Risk of bias and concerns of applicability by study using a modified Quadas-2 tool11
Goldberg, ‘82
Batool, ‘94
Ben-Baruch, ‘94
vdBosch, ‘95
vdBosch‘96 Low Low High Low Low Low Low
Giusa-Chifieri,’96 Unclear
Gupta, ‘96 Low
De Silva ‘97 Low
Mortakis ‘97 Unclear
O’Connell ‘97 Unclear
Bunyavejchevin Low ‘01
Epstein ‘01 Low Spicer ‘06 Low
Figure 2. Overall risk of bias
Unclear Low Low Unclear Unclear Low
Low Unclear
Unclear High Low Low Low Low Low Low Low Low Low Low Low Low Low
Unclear Low Low Low Low Unclear Low Low High High Low Low Low Low Low
Low Low Low Low Low Unclear Unclear Low Low Low
Unclear Unclear Unclear Low Unclear Unclear
Low High
The accuracy of endometrial sampling
Risk of bias
Applicability concerns
Patient selection
Index test
Reference standard
Flow and timing
Patient selection
Index test
Reference standard
Unclear Low Low Low Low Low Low Low Low Low Unclear High Low Low Low Unclear Low Low Low Low
High Unclear Low
and
applicability using a modified Quadas-2 tool.11
Proportion of studies with low, high or unclear risk of bias and applicability 7
Patient selection
Index test
Reference test
Flow and timing
Applicability
0%
25%
50%
75%
Diagnostic accuracy of endometrial sampling in women with PMB
Table 1 and 3 show the findings of the 12 included studies12-23.The Pipelle® device was used in eight studies,12,13,15-17,20-22 while the other studies reported on the use of Accurette®,23 Endorette®,18 and Novak endometrial sampler®.14 One study reported on two different sampling methods:Accurette® andVabra®.19
Blind D&C was used as the reference standard in five studies17-21 while hysteroscopy with histology (by biopsy and/or curettage) was the reference standard
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