Page 14 - EVALUATION OF TREATMENT FOR HEAVY MENSTRUAL BLEEDING by Herman, Malou

Chapter 1
Outline of the thesis
This thesis aims to answer the following questions:
1. What is the effectiveness of second-generation ablation techniques at
long-term follow-up?
2. Is there a relation between the Pictorial Blood Assessment Chart
score and treatment outcome?
3. Do patients prefer LNG-IUS or endometrial ablation in the treatment
of heavy menstrual bleeding?
4. What is the effectiveness of LNG-IUS compared to endometrial
ablation in the treatment of heavy menstrual bleeding?
5. What outcome measures are used in heavy menstrual bleeding
studies?
To answer these questions we conducted several studies which are described below. The results of these studies are presented in this thesis.
Chapter 2 gives an overview of the diagnosis of HBM, paying special attention to women’s perception of blood loss.
Chapter 3 presents 5-year follow-up results of a randomised controlled trial comparing the effectiveness of two second-generation ablation techniques: bipolar radiofrequency impedance controlled endometrial ablation (Novasure®) and hydrothermablation (HTA®).
Chapter 4 evaluates the results at 10-year follow-up after a randomised controlled trial comparing the effectiveness of two second-generation ablation techniques: bipolar radiofrequency impedance controlled endometrial ablation (Novasure®) and balloon endometrial ablation (Thermachoice®).
Chapter 5 focuses on the meaning of the PBAC score and the outcome after endometrial ablation. We included raw individual patient data (IPD) from all randomised controlled trials regarding endometrial ablation as a therapy for HMB.
Chapter 6 investigates patient preferences for endometrial ablation and LNG-IUS. A discrete choice experiment was used to assess women’s preferences.
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