Randomized trial of medical treatment versus hysterectomy for abnormal uterine bleeding: resource use in the Medicine or Surgery (Ms) trial.
OBJECTIVE
This study was undertaken to compare resource use outcomes for participants in the Medicine or Surgery (Ms) randomized trial.


METHODS
In a randomized controlled trial, we compared resources used during a 24-month follow-up period by women with abnormal uterine bleeding who were randomly assigned to either expanded medical treatment or hysterectomy.


RESULTS
Women randomly assigned to hysterectomy used significantly more resources (medicine = $4479, hysterectomy = $6777; P = .03), with almost all the difference caused by the hysterectomy procedure. Fifty-three percent of women randomly assigned to medicine had a hysterectomy during the follow-up period; women who were able to continue on medical therapy had mean total resource use of $2595 compared with $6128 for medicine patients who eventually had surgery.


CONCLUSIONS
For women with abnormal uterine bleeding refractory to cyclic medroxyprogesterone acetate, compared with expanded medical treatment, hysterectomy increases resource use significantly and results in better clinical and 6-month quality-of-life outcomes.
Showstack
Jonathan
J
Department of Medicine, University of California, San Francisco, CA, USA.
Lin
Feng
F
Learman
Lee A
LA
Vittinghoff
Eric
E
Kuppermann
Miriam
M
Varner
R Edward
RE
Summitt
Robert L
RL
McNeeley
S Gene
SG
Richter
Holly
H
Hulley
Stephen
S
Washington
A Eugene
AE
D000328:Adult; D003953:Diagnosis-Related Groups; D005260:Female; D006295:Health Resources / Q000706:statistics & numerical data*; D006801:Humans; D007044:Hysterectomy / Q000191:economics*; D008595:Menorrhagia / Q000188:drug therapy* / Q000191:economics / Q000601:surgery*; D008875:Middle Aged; D011247:Pregnancy; D011788:Quality of Life; D015895:Relative Value Scales; D016896:Treatment Outcome; D014481:United States