Comparison of office hysteroscopy and dilatation & curettage regarding patient comfort, efficacy and quality of life in patients suffering from menorrhagia: prospective randomized study
Bibliographic record
Abstract
Objective: Endometrial sampling is essential to exclude carcinoma and confirm the benign nature of abnormal uterine bleeding. Methods include endometrial biopsy, office hysteroscopy, and dilatation and curettage (D&C). The aim of this study was to evaluate the diagnostic efficacy of office hysteroscopy and D&C in patients suffering from menorrhagia, and to compare the tolerability and the outcome of the two procedures. Materials and Methods: Forty patients suffering from menorrhagia and willing to participate were included in this prospective study and randomized to office hysteroscopy (n=20) and D&C groups (n=20). Quality of life was evaluated using the Menorrhagia- Impact-Questionnaire (MIQ) before and three months after the procedure. Visual analogue scale (VAS) was used to evaluate the pain felt during the procedure. Primary outcomes were patient-reported improvement in menorrhagia and effect on quality of life. Secondary outcomes were objective improvement in the complete-blood-count, tolerability and complications of the procedure, and pathology results. Results: There was a significant difference in the mean VAS results for pain in the office hysteroscopy and D&C groups (p = 0.00). In the MIQ domains, there was a significant improvement in the perception of blood loss in both groups, which was more significant in the office hysteroscopy group when compared to the D&C group. There was a significant improvement in the limitations in work inside/outside home, limitations in physical and social activities in the office hysteroscopy group, and the differences were significant when compared with the D&C group. In the assessment of change in blood loss, the difference between the two groups after the procedure was significant. Twenty patients (100%) in the office hysteroscopy group and 19 patients (95%) in the D&C group suggested that this was a remarkable and important change. Two patients in each group had insufficient tissue for diagnosis. Eight patients in the office hysteroscopy group whereas three patients in the D&C group had endometrial polyps. In one patient in the D&C group, pathology result was submucous leiomyoma. Conclusion: There was a significant patient-reported improvement in menorrhagia and positive effect on quality of life after office hysteroscopy when compared to D&C. Pain was significantly less in the office hysteroscopy when compared to D&C even in patients with lower number of deliveries. Office hysteroscopy was superior to D&C in the diagnosis of intracavitary pathologies.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.030 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".