Experience with shared decision making in gynaecological practice: treatment decisions in patients with dysfunctional uterine blood loss.
OBJECTIVE
To study the impact of introducing a blood loss chart as a means to support treatment selection in women with dysfunctional uterine blood loss.


METHODS
Retrospective chart review, prospective observational study, and decision modelling.


RESULTS
Introduction of a blood loss chart resulted in a 50% reduction of re-treatments within 1 year (from 25% to 12.5%). The use of the blood loss chart resulted in a slightly higher expected value and lower costs, which is reflected in a more favourable cost/quality adjusted life year (QALY) ratio.


CONCLUSIONS
The use of a blood loss chart as an aid in treatment selection in women with dysfunctional uterine blood loss is feasible. Although its use requires an extra outpatient visit, the associated extra costs are off-set by its impact on initial treatment selection, and, in particular, on the probability of re-treatment within 1 year of follow-up.
van der Wilt
Gert Jan
GJ
Department of Medical Technology Assessment, University Medical Centre St Radboud, PO Box 9101, 6500 HB Nijmegen, The Netherlands. g.vanderwilt@mta.umcn.nl
Meulendijks
Carina F M
CF
Thijssen
Robbert F A
RF
D000328:Adult; D003661:Decision Support Techniques; D004717:Endometrium / Q000601:surgery; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007044:Hysterectomy; D016912:Levonorgestrel / Q000008:administration & dosage; D008595:Menorrhagia / Q000191:economics / Q000628:therapy*; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012008:Recurrence; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
D016912:Levonorgestrel