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https://hdl.handle.net/2440/85455
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Type: | Journal article |
Title: | Factors attributing to the failure of endometrial sampling in women with postmenopausal bleeding |
Author: | Visser, N. Breijer, M. Herman, M. Bekkers, R. Veersema, S. Opmeer, B. Mol, B. Timmermans, A. Pijnenborg, J. |
Citation: | Acta Obstetricia et Gynecologica Scandinavica, 2013; 92(10):1216-1222 |
Publisher: | Munksgaard International Publishers |
Issue Date: | 2013 |
ISSN: | 0001-6349 1600-0412 |
Statement of Responsibility: | Nicole C.M. Visser, Maria C. Breijer, Malou C. Herman, Ruud L.M. Bekkers, Sebastiaan Veersema, Brent C. Opmeer, Ben W.J. Mol, Anne Timmermans and Johanna M.A. Pijnenborg |
Abstract: | Objective: To determine which doctor- and patient-related factors affect failure of outpatient endometrial sampling in women with postmenopausal bleeding, and to develop a multivariable prediction model to select women with a high probability of failed sampling. Design: Prospective multicenter cohort study. Setting: Three teaching hospitals in the Netherlands. Population: Women presenting with postmenopausal bleeding with an indication for endometrial sampling. Methods: Multivariable logistic regression was performed to evaluate the impact of doctor's training level and patient's characteristics on failure of sampling. Main outcome measures: Failure of endometrial sampling, classified as technical failure or insufficient tissue for diagnosis. Results: In 74 (20.8%) of the 356 included women, sampling technically failed, and in 84 (29.8%) the amount of tissue was insufficient for diagnosis. Nulliparity [odds ratio (OR) 3.8, 95% confidence interval (CI) 1.8–7.9] and advanced age (OR 1.03 per year, 95% CI 1.00–1.06) were associated with technical failure. Advanced age was associated with insufficient sampling (OR 1.04 per year, 95% CI 1.01–1.07), and endometrial thickness >12 mm decreased the chance of insufficient sampling (OR 0.3, 95%CI 0.1–0.8). The prediction model for total failure had an area under the ROC curve of 0.64 (95% CI 0.58–0.70). Conclusions: In women with postmenopausal bleeding, the failure rate of endometrial sampling is relatively high and is associated with nulliparity and advanced age. Endometrial thickness >12 mm decreased the chance of failure. A multivariable prediction model for total failure based on patient characteristics has a moderate capacity to discriminate between women at high or low risk of failure. |
Keywords: | Endometrial sampling; non-diagnostic sample; postmenopausal bleeding; prediction model; risk factors |
Rights: | © 2013 Nordic Federation of Societies of Obstetrics and Gynecology |
DOI: | 10.1111/aogs.12212 |
Published version: | http://dx.doi.org/10.1111/aogs.12212 |
Appears in Collections: | Aurora harvest 7 Obstetrics and Gynaecology publications |
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