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Original Article
External Validation of Models to Predict Unsuccessful Endometrial Ablation: A Retrospective Study
Kelly Yvonne Roger Stevens
Catharina Ziekenhuis
Corresponding Author
ORCiD: https://orcid.org/0000-0003-3512-9181
License:
This work is licensed under a CC BY 4.0 License. Read Full License
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.
Keywords
Endometrial ablation, external validation, prediction model
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CURRENT STATUS: Under Review
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Reviewer #1 agreed
On 14 Feb, 2021
Review #1 received
Received 14 Feb, 2021
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On 11 Feb, 2021
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Subject Areas
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This preprint is under consideration at Gynecological Surgery. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Original Article
External Validation of Models to Predict Unsuccessful Endometrial Ablation: A Retrospective Study
Kelly Yvonne Roger Stevens
Catharina Ziekenhuis
Corresponding Author
ORCiD: https://orcid.org/0000-0003-3512-9181
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 22 Feb, 2021
No community comments so far
Reviewer #2 agreed
On 14 Feb, 2021
Reviewer #1 agreed
On 14 Feb, 2021
Review #1 received
Received 14 Feb, 2021
Reviewers invited
Invitations sent on 13 Feb, 2021
Editor assigned
On 11 Feb, 2021
Submission checks complete
On 11 Feb, 2021
Editor invited
On 11 Feb, 2021
First submitted
On 07 Feb, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Obstetrics & Gynecology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
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.