A systematic review evaluating health-related quality of life, work impairment, and health-care costs and utilization in abnormal uterine bleeding.
OBJECTIVE
Abnormal uterine bleeding (AUB) impacts women's health-related quality of life (HRQoL) and puts a heavy economic burden on society. To date, this burden has not been systematically studied. We conducted a systematic review of the medical literature to evaluate the impact of AUB on HRQoL and to quantify the economic burden of AUB from a societal perspective.


METHODS
We searched the PubMed and Cochrane databases, and article bibliographies for the period up to July 2005. Teams of two reviewers independently abstracted data from studies that reported outcomes of interest: prevalence, HRQoL, work impairment, and health-care utilization and costs associated with AUB.


RESULTS
The search yielded 1009 English-language articles. Ninety-eight studies (including randomized controlled trials, observational studies, and reviews) that met the inclusion and exclusion criteria underwent a full-text review. The prevalence of AUB among women of reproductive age ranged from 10% to 30%. The HRQoL scores from the 36-item Short-Form Health Survey Questionnaire (SF-36) suggested that women with AUB have HRQoL below the 25th percentile of that for the general female population within a similar age range. The conservatively estimated annual direct and indirect economic costs of AUB were approximately $1 billion and $12 billion, respectively. These figures do not account for intangible costs and productivity loss due to presenteeism.


CONCLUSIONS
The burden of AUB needs further and more thorough investigation. Additional research should prospectively evaluate the impact of AUB and the value of treatment provided to help guide future health resource allocation and clinical decision-making.
Liu
Zhimei
Z
Cerner LifeSciences, 9100 Wilshire Boulevard, Beverly Hills, CA 90212, USA. zliu@cerner.com
Doan
Quan V
QV
Blumenthal
Paul
P
Dubois
Robert W
RW
D000328:Adult; D017281:Cost of Illness; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006296:Health Services / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D008796:Metrorrhagia / Q000150:complications* / Q000191:economics* / Q000523:psychology / Q000628:therapy; D011788:Quality of Life; D018582:Sick Leave / Q000191:economics