Skip to main content

Diagnostic hysteroscopy in abnormal uterine bleeding: a systematic review and meta-analysis

Buy Article:

$51.00 plus tax (Refund Policy)

Background

This study was conducted to assess the accuracy and feasibility of diagnostic hysteroscopy in the evaluation of intrauterine abnormalities in women with abnormal uterine bleeding. Search strategy

Electronic databases were searched from 1 January 1965 to 1 January 2006 without language selection. The medical subject heading (MeSH) and textwords for the following terms were used: hysteroscopy, diagnosis, histology, histopathology, hysterectomy, biopsy, sensitivity and specificity. Setting

University Hospital. Selection criteria

The inclusion criteria were report on accuracy of diagnostic hysteroscopy in women with abnormal uterine bleeding compared to histology collected with guided biopsy during hysteroscopy, operative hysteroscopy or hysterectomy. Data collection and analysis

Electronic databases were searched for relevant studies and references were cross-checked. Validity was assessed and data were extracted independently by two authors. Heterogeneity was calculated and data were pooled. Subgroup analysis was performed according to validity criteria, study quality, menopausal state, time, setting and performance of the procedure. The pooled sensitivity, specificity, likelihood ratios, post-test probabilities and feasibility of diagnostic hysteroscopy on the prediction of uterine cavity abnormalities. Post-test probabilities were derived from the likelihood ratios and prevalence of intrauterine abnormalities among included studies. Feasibility included technical success rate and complication rate. Main results

One population of homogeneous data could be identified, consisting of patients with postmenopausal bleeding. In this subgroup the positive and negative likelihood ratios were 7.9 (95% CI 4.79–13.10) and 0.04 (95% CI 0.02–0.09), raising the pre-test probability from 0.61 to a post-test probability of 0.93 (95% CI 0.88–0.95) for positive results and reducing it to 0.06 (95% CI 0.03–0.13) for negative results. The pooled likelihood ratios of all studies included, calculated with the random effects model, were 6.5 (95% CI 4.1–10.4) and 0.08 (95% CI 0.07–0.10), changing the pre-test probability of 0.46 to post-test probabilities of 0.85 (95% CI 0.78–0.90) and 0.07 (0.06–0.08) for positive and negative results respectively. Subgroup analyses gave similar results. The overall success rate of diagnostic hysteroscopy was estimated at 96.9% (SD 5.2%, range 83–100%). Conclusions

This systematic review and meta-analysis shows that diagnostic hysteroscopy is both accurate and feasible in the diagnosis of intrauterine abnormalities.
No References
No Citations
No Supplementary Data
No Data/Media
No Metrics

Keywords: Accuracy; bleeding disorders; diagnosis; hysteroscopy; meta-analysis

Document Type: Research Article

Affiliations: 1: Departments of Gynaecology 2: Medical Decision Making, Leiden University Medical Center, Leiden, the Netherlands

Publication date: 2007-06-01

  • Access Key
  • Free content
  • Partial Free content
  • New content
  • Open access content
  • Partial Open access content
  • Subscribed content
  • Partial Subscribed content
  • Free trial content
Cookie Policy
X
Cookie Policy
Ingenta Connect website makes use of cookies so as to keep track of data that you have filled in. I am Happy with this Find out more