External Validation of Models to Predict Unsuccessful Endometrial Ablation: A Retrospective Study
Study Objective: External validation of previously presented and locally established prediction models to help counsel patients for failure of endometrial ablation (EA) or surgical re-intervention within 2 years after EA, called ‘Failure model’ and ‘Re-intervention model’ respectively.
Design: Retrospective external validation study, minimal follow-up time of 2 years.
Setting: Two non-academic teaching hospitals in the Netherlands.
Patients: Pre-menopausal women (18+) who had undergone EA for abnormal uterine bleeding problems between January 2010 and November 2012. A total of 329 patients were eligible for analysis.
Interventions: Interventions used for EA were Novasure (Hologic, Marlborough, Massachusetts, US) and ThermaChoice III (Ethicon, Sommerville, US).
Measurements and Main Results: The Area Under the Receiver Operating characteristics Curve (AUROC) for the outcome parameter of failure within 2 years after EA was 0.59 (95% CI 0.53 – 0.65). Variables in this model were dysmenorrhea, age, parity ≥5 and preoperative menorrhagia. The Hosmer-Lemeshow test showed no significant difference between the observed and predicted outcome. (Chi-square: 4.62, P-value: .80) The AUROC for the outcome parameter surgical re-intervention within 2 years was 0.62 (95% CI 0.53 – 0.70) Variables in this model were dysmenorrhea, age, menstrual duration> 7 days, parity ≥5 and a previous caesarean section. The Hosmer-Lemeshow test showed no significant difference between the observed and predicted outcome (Chi-square 11.34, P-value .18).
Conclusion: Both the failure model and the re-intervention model can be used to predict unsuccessful endometrial ablation in the general population within two years after the procedure. It can be used prior to surgery to facilitate tailor-made shared decision-making, and help counsel patients with regards to the potential outcome of their treatment with the use of a personally calculated percentage.
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Due to technical limitations, full-text HTML conversion of this manuscript could not be completed. However, the manuscript can be downloaded and accessed as a PDF.
Posted 22 Feb, 2021
On 14 Feb, 2021
On 14 Feb, 2021
Received 14 Feb, 2021
Invitations sent on 13 Feb, 2021
On 11 Feb, 2021
On 11 Feb, 2021
On 11 Feb, 2021
On 07 Feb, 2021
External Validation of Models to Predict Unsuccessful Endometrial Ablation: A Retrospective Study
Posted 22 Feb, 2021
On 14 Feb, 2021
On 14 Feb, 2021
Received 14 Feb, 2021
Invitations sent on 13 Feb, 2021
On 11 Feb, 2021
On 11 Feb, 2021
On 11 Feb, 2021
On 07 Feb, 2021
Study Objective: External validation of previously presented and locally established prediction models to help counsel patients for failure of endometrial ablation (EA) or surgical re-intervention within 2 years after EA, called ‘Failure model’ and ‘Re-intervention model’ respectively.
Design: Retrospective external validation study, minimal follow-up time of 2 years.
Setting: Two non-academic teaching hospitals in the Netherlands.
Patients: Pre-menopausal women (18+) who had undergone EA for abnormal uterine bleeding problems between January 2010 and November 2012. A total of 329 patients were eligible for analysis.
Interventions: Interventions used for EA were Novasure (Hologic, Marlborough, Massachusetts, US) and ThermaChoice III (Ethicon, Sommerville, US).
Measurements and Main Results: The Area Under the Receiver Operating characteristics Curve (AUROC) for the outcome parameter of failure within 2 years after EA was 0.59 (95% CI 0.53 – 0.65). Variables in this model were dysmenorrhea, age, parity ≥5 and preoperative menorrhagia. The Hosmer-Lemeshow test showed no significant difference between the observed and predicted outcome. (Chi-square: 4.62, P-value: .80) The AUROC for the outcome parameter surgical re-intervention within 2 years was 0.62 (95% CI 0.53 – 0.70) Variables in this model were dysmenorrhea, age, menstrual duration> 7 days, parity ≥5 and a previous caesarean section. The Hosmer-Lemeshow test showed no significant difference between the observed and predicted outcome (Chi-square 11.34, P-value .18).
Conclusion: Both the failure model and the re-intervention model can be used to predict unsuccessful endometrial ablation in the general population within two years after the procedure. It can be used prior to surgery to facilitate tailor-made shared decision-making, and help counsel patients with regards to the potential outcome of their treatment with the use of a personally calculated percentage.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
Figure 6
Figure 7
Due to technical limitations, full-text HTML conversion of this manuscript could not be completed. However, the manuscript can be downloaded and accessed as a PDF.