title: Randomized trial of medical treatment versus hysterectomy for abnormal uterine bleeding: resource use in the Medicine or Surgery (Ms) trial.
abstract: 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.
authors.affiliation: Department of Medicine, University of California, San Francisco, CA, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Showstack
authors.forename: Feng
authors.initials: F
authors.lastname: Lin
authors.forename: Lee A
authors.initials: LA
authors.lastname: Learman
authors.forename: Eric
authors.initials: E
authors.lastname: Vittinghoff
authors.forename: Miriam
authors.initials: M
authors.lastname: Kuppermann
authors.forename: R Edward
authors.initials: RE
authors.lastname: Varner
authors.forename: Robert L
authors.initials: RL
authors.lastname: Summitt
authors.forename: S Gene
authors.initials: SG
authors.lastname: McNeeley
authors.forename: Holly
authors.initials: H
authors.lastname: Richter
authors.forename: Stephen
authors.initials: S
authors.lastname: Hulley
authors.forename: A Eugene
authors.initials: AE
authors.lastname: Washington
mesh_terms: 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