Page 56 - The diagnostic work-up of women with postmenopausal bleeding

Chapter 3
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Table 1. Study characteristics of included articles
First author, year
Epstein 2002
Patients
Exclusion criteria N
N malignancy (%)
16 (19%)
Age (years)
Study design
Outcome
Prediction model
Randelz-hofer 2002
Bachmann 2003
PMP bleeding, unscheduled bleeding on HRT
- 428
95 (30%) 19 (4.6%)
47-91 (median 68) 28-61 (median 54)
4 models: patient history, patient history + US, patient history + hyst, patient history +TVS + hyst
1 model: patient histor y + TVS
Bruchim 2004 Opmeer 2006
PMP bleeding PMP bleeding
HRT use 95
9 (9.5%) 56 (10.3%)
46-94 (mean 60) 37-91 (mean 62)
Cohor t*
Endometrial cancer Endometrial cancer or precancer
Opolskiene 2007
PMP bleeding, ET 4.5 mm
Fluid in cavity, absence of 120 power Doppler signals,
large myomas, no histologic diagnosis
30 (25%)
*
Prospective cohor t
Endometrial cancer
Burbos 2010 Burbos 2011 Opolskiene 2011
PMP bleeding PMP bleeding
Asymptomatic women 3047
-
201 (6%) 63 (24%)
35-97 (median 59) 54-73
Prospective cohor t Prospective cohor t Prospective cohor t
Endometrial cancer Endometrial cancer Endometrial cancer
1 model: patient histor y + TVS
PMP = postmenopausal
ET = endometrial thickness
CH = cohort study
Hyst = hysteroscopy (pos/neg)
TVS = transvaginal sonography
HRT = hormone replacement therapy
TVS + Doppler
* not well described
PMP bleeding, ET 5mm
PMP bleeding
Doppler artefacts, 83 incorrect processing HRT/Tamoxifen use 321
Mean 66
Prospective cohor t Prospective cohor t Prospective cohor t
Endometrial cancer Endometrial cancer Endometrial cancer
2 models: both combination patient history,TVS and Doppler 1 model:TVS only
PMP bleeding, ET 4.5 mm
ultrasound images or reliable histologic diagnosis
47-91 (median 67)
4 models: one based on patient histor y, 1 patient histor y + TVS, 2 patient history +
History of hysterectomy, 540 HRT use, recurrent bleeding,TVS not possible/
not performed
Prospective cohor t
2 models: patient characteristics and one combined model with patient characteristics and TVS
Many models:TVS and Doppler
History of hysterectomy, 3548 asymptomatic women
Absence of processed 261
1 model: patient history only