Page 29 - EVALUATION OF TREATMENT FOR HEAVY MENSTRUAL BLEEDING by Herman, Malou

Pictorial Blood Assessment Chart and endometrial ablation outcome
The cut-off point is 75% with a sensitivity of 0.79 and specificity of 0.88. After correction for study, the AUC is 0.93. The best cut-off value is then 74% with a sensitivity of 0.91 and a specificity of 0.86. Table 3 shows different percentages of reduction in PBAC with its sensitivity and specificity.
Table 3: Sensitivity and specificity for some percentages reduction in PBAC score regarding satisfaction and re-intervention
0 100 21 10 100 27 20 100 32 30 99 40 40 99 49 50 98 46 60 97 61 70 96 66 75**
80 92 72
89* 84 84
90 82 84 100 42 100
PBAC = Pictorial Blood Assessment Chart
* Best cutoff point in ROC for satisfaction
** Best cutoff point in ROC for re-intervention
Discussion
Main findings
Reduction PBAC score (%)
Sensitivity %
Satisfaction
Specificity %
Satisfaction
Sensitivity %
Re-intervention
Specificity %
Re-intervention
23 98
28 98
38 98
43 96
49 95
55 94
59 93
74 91
77 88
79 86 - - 90 72 100 31
We studied the meaning of the Pictorial Blood Assessment Chart score (PBAC) after endometrial ablation. The PBAC score 12 months after treatment and reduction of PBAC score in percentages are significantly associated with satisfaction and re-intervention rates. PBAC demonstrated high accuracy for both treatment outcomes. The best cut-off value for PBAC at 12 months regarding satisfaction, with the highest sensitivity and specificity, can be found at 59 points or at a reduction of around 90% in PBAC score. For re-intervention this threshold lies at 98 points or a decrease of 75% in score. On the other hand, most women who
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