Is the Pictorial Blood Loss Assessment Chart (PBAC) score associated with treatment outcome after endometrial ablation for heavy menstrual bleeding?: A cohort study

M C Herman; N Mak; P M Geomini; B Winkens; B W Mol; M Y Bongers; International Heavy Menstrual Bleeding IPD Meta-analysis Collaborative Group

doi:10.1111/1471-0528.14434

Is the Pictorial Blood Loss Assessment Chart (PBAC) score associated with treatment outcome after endometrial ablation for heavy menstrual bleeding? A cohort study

M C Herman^*, N Mak, P M Geomini, B Winkens, B W Mol, M Y Bongers, International Heavy Menstrual Bleeding IPD Meta-analysis Collaborative Group

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

OBJECTIVE: The Pictorial Blood Loss Assessment Chart (PBAC) is a validated tool that is used to diagnose heavy menstrual bleeding (HMB). Knowledge of the effect of its score and its relationship with outcome could have implications for using the PBAC as an outcome measurement in future HMB studies, and as a tool to evaluate the treatment effect in research and clinical practice. Our aim was to relate PBAC scores to other measures of success after endometrial ablation for HMB.

DESIGN: Analysis of individual patient data (IPD) of randomised controlled trials studying women with HMB.

SETTING: Women with HMB consulting their gynecologists.

POPULATION OR SAMPLE: Individual patient data (IPD) of randomised controlled trials studying women with HMB.

METHODS: We included studies if they had studied second-generation endometrial ablation techniques and had collected PBAC scores for both baseline and follow-up. The effectiveness of treatment was scored as satisfaction or re-intervention (yes/no) 12 months after treatment. We related these outcomes to the PBAC score at 12 months after treatment, and to PBAC decrease between baseline and 12 months of follow-up.

RESULTS: We studied data for 900 patients included in nine studies. The median PBAC score at 12 months was 7 (0-2500). The overall satisfaction rate was 89% and the overall re-intervention rate was 7.2%. A clear association was found between absolute PBAC score at the 12-month follow-up and satisfaction (odds ratio, OR 0.16; 95% confidence interval, 95% CI 0.11-0.24) and surgical re-intervention (OR 2.3, 95% CI 1.8-2.8). A change in PBAC score was also associated with satisfaction (OR 2.0, 95% CI 1.7-2.3) and surgical re-intervention (OR 0.69, 95% CI 0.63-0.75). Both the absolute PBAC scores and the changes in score show high accuracy for both treatment outcomes.

CONCLUSIONS: PBAC scores at 12 months after treatment are significantly associated with satisfaction and re-intervention rates. We propose to use the PBAC in research as a primary end point in studies on HMB, and in clinical practice as a measure to assess the effectiveness of treatment.

TWEETABLE ABSTRACT: PBAC scores 12 months after treatment are significantly associated with satisfaction and reintervention rates.

Original language	English
Pages (from-to)	277-282
Number of pages	6
Journal	Bjog-an International Journal of Obstetrics and Gynaecology
Volume	124
Issue number	2
DOIs	https://doi.org/10.1111/1471-0528.14434
Publication status	Published - Jan 2017

Keywords

Journal Article
THERMAL BALLOON
MENORRHAGIA
SYSTEM
RANDOMIZED-CONTROLLED-TRIAL
POPULATION
MULTICENTER
endometrial ablation
Pictorial Blood Loss Assessment Chart
heavy menstrual bleeding
BIPOLAR

Access to Document

10.1111/1471-0528.14434

Cite this

Herman, M. C., Mak, N., Geomini, P. M., Winkens, B., Mol, B. W., Bongers, M. Y., & International Heavy Menstrual Bleeding IPD Meta-analysis Collaborative Group (2017). Is the Pictorial Blood Loss Assessment Chart (PBAC) score associated with treatment outcome after endometrial ablation for heavy menstrual bleeding? A cohort study. Bjog-an International Journal of Obstetrics and Gynaecology, 124(2), 277-282. https://doi.org/10.1111/1471-0528.14434

@article{0c301e16a7d44ed3bc3f5fceec522e28,

title = "Is the Pictorial Blood Loss Assessment Chart (PBAC) score associated with treatment outcome after endometrial ablation for heavy menstrual bleeding?: A cohort study",

abstract = "OBJECTIVE: The Pictorial Blood Loss Assessment Chart (PBAC) is a validated tool that is used to diagnose heavy menstrual bleeding (HMB). Knowledge of the effect of its score and its relationship with outcome could have implications for using the PBAC as an outcome measurement in future HMB studies, and as a tool to evaluate the treatment effect in research and clinical practice. Our aim was to relate PBAC scores to other measures of success after endometrial ablation for HMB.DESIGN: Analysis of individual patient data (IPD) of randomised controlled trials studying women with HMB.SETTING: Women with HMB consulting their gynecologists.POPULATION OR SAMPLE: Individual patient data (IPD) of randomised controlled trials studying women with HMB.METHODS: We included studies if they had studied second-generation endometrial ablation techniques and had collected PBAC scores for both baseline and follow-up. The effectiveness of treatment was scored as satisfaction or re-intervention (yes/no) 12 months after treatment. We related these outcomes to the PBAC score at 12 months after treatment, and to PBAC decrease between baseline and 12 months of follow-up.RESULTS: We studied data for 900 patients included in nine studies. The median PBAC score at 12 months was 7 (0-2500). The overall satisfaction rate was 89% and the overall re-intervention rate was 7.2%. A clear association was found between absolute PBAC score at the 12-month follow-up and satisfaction (odds ratio, OR 0.16; 95% confidence interval, 95% CI 0.11-0.24) and surgical re-intervention (OR 2.3, 95% CI 1.8-2.8). A change in PBAC score was also associated with satisfaction (OR 2.0, 95% CI 1.7-2.3) and surgical re-intervention (OR 0.69, 95% CI 0.63-0.75). Both the absolute PBAC scores and the changes in score show high accuracy for both treatment outcomes.CONCLUSIONS: PBAC scores at 12 months after treatment are significantly associated with satisfaction and re-intervention rates. We propose to use the PBAC in research as a primary end point in studies on HMB, and in clinical practice as a measure to assess the effectiveness of treatment.TWEETABLE ABSTRACT: PBAC scores 12 months after treatment are significantly associated with satisfaction and reintervention rates.",

keywords = "Journal Article, THERMAL BALLOON, MENORRHAGIA, SYSTEM, RANDOMIZED-CONTROLLED-TRIAL, POPULATION, MULTICENTER, endometrial ablation, Pictorial Blood Loss Assessment Chart, heavy menstrual bleeding, BIPOLAR",

author = "Herman, {M C} and N Mak and Geomini, {P M} and B Winkens and Mol, {B W} and Bongers, {M Y} and {International Heavy Menstrual Bleeding IPD Meta-analysis Collaborative Group}",

note = "{\textcopyright} 2016 Royal College of Obstetricians and Gynaecologists.",

year = "2017",

month = jan,

doi = "10.1111/1471-0528.14434",

language = "English",

volume = "124",

pages = "277--282",

journal = "Bjog-an International Journal of Obstetrics and Gynaecology",

issn = "1470-0328",

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number = "2",

}

Herman, MC, Mak, N, Geomini, PM, Winkens, B, Mol, BW, Bongers, MY & International Heavy Menstrual Bleeding IPD Meta-analysis Collaborative Group 2017, 'Is the Pictorial Blood Loss Assessment Chart (PBAC) score associated with treatment outcome after endometrial ablation for heavy menstrual bleeding? A cohort study', Bjog-an International Journal of Obstetrics and Gynaecology, vol. 124, no. 2, pp. 277-282. https://doi.org/10.1111/1471-0528.14434

Is the Pictorial Blood Loss Assessment Chart (PBAC) score associated with treatment outcome after endometrial ablation for heavy menstrual bleeding? A cohort study. / Herman, M C; Mak, N; Geomini, P M et al.
In: Bjog-an International Journal of Obstetrics and Gynaecology, Vol. 124, No. 2, 01.2017, p. 277-282.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Is the Pictorial Blood Loss Assessment Chart (PBAC) score associated with treatment outcome after endometrial ablation for heavy menstrual bleeding?

T2 - A cohort study

AU - Herman, M C

AU - Mak, N

AU - Geomini, P M

AU - Winkens, B

AU - Mol, B W

AU - Bongers, M Y

AU - International Heavy Menstrual Bleeding IPD Meta-analysis Collaborative Group

PY - 2017/1

Y1 - 2017/1

N2 - OBJECTIVE: The Pictorial Blood Loss Assessment Chart (PBAC) is a validated tool that is used to diagnose heavy menstrual bleeding (HMB). Knowledge of the effect of its score and its relationship with outcome could have implications for using the PBAC as an outcome measurement in future HMB studies, and as a tool to evaluate the treatment effect in research and clinical practice. Our aim was to relate PBAC scores to other measures of success after endometrial ablation for HMB.DESIGN: Analysis of individual patient data (IPD) of randomised controlled trials studying women with HMB.SETTING: Women with HMB consulting their gynecologists.POPULATION OR SAMPLE: Individual patient data (IPD) of randomised controlled trials studying women with HMB.METHODS: We included studies if they had studied second-generation endometrial ablation techniques and had collected PBAC scores for both baseline and follow-up. The effectiveness of treatment was scored as satisfaction or re-intervention (yes/no) 12 months after treatment. We related these outcomes to the PBAC score at 12 months after treatment, and to PBAC decrease between baseline and 12 months of follow-up.RESULTS: We studied data for 900 patients included in nine studies. The median PBAC score at 12 months was 7 (0-2500). The overall satisfaction rate was 89% and the overall re-intervention rate was 7.2%. A clear association was found between absolute PBAC score at the 12-month follow-up and satisfaction (odds ratio, OR 0.16; 95% confidence interval, 95% CI 0.11-0.24) and surgical re-intervention (OR 2.3, 95% CI 1.8-2.8). A change in PBAC score was also associated with satisfaction (OR 2.0, 95% CI 1.7-2.3) and surgical re-intervention (OR 0.69, 95% CI 0.63-0.75). Both the absolute PBAC scores and the changes in score show high accuracy for both treatment outcomes.CONCLUSIONS: PBAC scores at 12 months after treatment are significantly associated with satisfaction and re-intervention rates. We propose to use the PBAC in research as a primary end point in studies on HMB, and in clinical practice as a measure to assess the effectiveness of treatment.TWEETABLE ABSTRACT: PBAC scores 12 months after treatment are significantly associated with satisfaction and reintervention rates.

AB - OBJECTIVE: The Pictorial Blood Loss Assessment Chart (PBAC) is a validated tool that is used to diagnose heavy menstrual bleeding (HMB). Knowledge of the effect of its score and its relationship with outcome could have implications for using the PBAC as an outcome measurement in future HMB studies, and as a tool to evaluate the treatment effect in research and clinical practice. Our aim was to relate PBAC scores to other measures of success after endometrial ablation for HMB.DESIGN: Analysis of individual patient data (IPD) of randomised controlled trials studying women with HMB.SETTING: Women with HMB consulting their gynecologists.POPULATION OR SAMPLE: Individual patient data (IPD) of randomised controlled trials studying women with HMB.METHODS: We included studies if they had studied second-generation endometrial ablation techniques and had collected PBAC scores for both baseline and follow-up. The effectiveness of treatment was scored as satisfaction or re-intervention (yes/no) 12 months after treatment. We related these outcomes to the PBAC score at 12 months after treatment, and to PBAC decrease between baseline and 12 months of follow-up.RESULTS: We studied data for 900 patients included in nine studies. The median PBAC score at 12 months was 7 (0-2500). The overall satisfaction rate was 89% and the overall re-intervention rate was 7.2%. A clear association was found between absolute PBAC score at the 12-month follow-up and satisfaction (odds ratio, OR 0.16; 95% confidence interval, 95% CI 0.11-0.24) and surgical re-intervention (OR 2.3, 95% CI 1.8-2.8). A change in PBAC score was also associated with satisfaction (OR 2.0, 95% CI 1.7-2.3) and surgical re-intervention (OR 0.69, 95% CI 0.63-0.75). Both the absolute PBAC scores and the changes in score show high accuracy for both treatment outcomes.CONCLUSIONS: PBAC scores at 12 months after treatment are significantly associated with satisfaction and re-intervention rates. We propose to use the PBAC in research as a primary end point in studies on HMB, and in clinical practice as a measure to assess the effectiveness of treatment.TWEETABLE ABSTRACT: PBAC scores 12 months after treatment are significantly associated with satisfaction and reintervention rates.

KW - Journal Article

KW - THERMAL BALLOON

KW - MENORRHAGIA

KW - SYSTEM

KW - RANDOMIZED-CONTROLLED-TRIAL

KW - POPULATION

KW - MULTICENTER

KW - endometrial ablation

KW - Pictorial Blood Loss Assessment Chart

KW - heavy menstrual bleeding

KW - BIPOLAR

U2 - 10.1111/1471-0528.14434

DO - 10.1111/1471-0528.14434

M3 - Article

C2 - 28012272

SN - 1470-0328

VL - 124

SP - 277

EP - 282

JO - Bjog-an International Journal of Obstetrics and Gynaecology

JF - Bjog-an International Journal of Obstetrics and Gynaecology

IS - 2

ER -