AHCPR Funding Studies On Hysterectomy Vs. Alternative Treatment For Uterine Conditions

The Agency for Health Care Policy and Research (AHCPR) today announced the start of three research projects to determine the outcomes of surgery versus other treatments for dysfunctional uterine bleeding (DUB), as well as patient treatment preferences for women with endometriosis, chronic pelvic pain, fibroids, uterine prolapse or DUB.

Each year in the United States, 590,000 women have hysterectomies for various conditions. The majority of hysterectomies are performed before menopause, often for abnormal uterine bleeding. U.S. hysterectomy rates are much higher than in other Western nations, and rates vary by geographic region, ethnicity and socioeconomic status. Although alternative treatments are available, there is little data that compares these treatments to hysterectomy, or various types of hysterectomy to each other. This lack of information makes it more difficult for women to choose the best treatment option.

The following studies resulted from a "Request For Application" issued by AHCPR March 1. The total amount of the awards is $17.4 million over five years. The studies are:

- Surgical Treatments Outcomes Project for Dysfunctional Uterine Bleeding. Principal Investigator Kay Dickersin, University of Maryland at Baltimore. HS09506. 1996-2001. The purpose of this study is to determine the equivalence of two therapies for DUB--hysterectomy and endometrial ablation--using two randomized controlled trials. The study will examine the natural history of DUB, the effectiveness of treatment and cost. - MEDTEP Study on Hysterectomy and Dysfunctional Uterine Bleeding. Principal Investigator Sarah E. Fowler. Case-Western/Henry Ford Health Sciences Center, Detroit, Mich. HS09502. 1996-2001. Using collaborative, multisite, randomized controlled trials, this study will compare the effectiveness, relative costs and patient outcomes of hysterectomy, endometrial ablation and hormone therapy for women with dysfunctional uterine bleeding. - Medicine Or Surgery? Principal Investigator Stephen B. Hulley, University of California at San Francisco. HS09478. 1996-2001.

The study will run two randomly controlled trials: one to compare the effects (including quality of life) and costs of medical therapy versus hysterectomy; the other to compare the effects of supracervical versus total hysterectomy on function and well-being in women who undergo abdominal hysterectomy. The study also will determine rates and patient preferences for management options for women with diagnoses of fibroids, dysfunctional uterine bleeding, chronic pelvic pain, endometriosis or uterine prolapse.

Note: HHS press releases are available on the World Wide Web at: http://www.hhs.gov.

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