Endometrial Thickness Measurement for Detecting Endometrial Cancer in Women With Postmenopausal Bleeding A Systematic Review and Meta-Analysis

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dc.contributor.authorTimmermans, Anne
dc.contributor.authorOpmeer, Brent C.
dc.contributor.authorKhan, Khalid S.
dc.contributor.authorBachmann, Lucas M.
dc.contributor.authorEpstein, Elisabeth
dc.contributor.authorClark, T. Justin
dc.contributor.authorGupta, Janesh K.
dc.contributor.authorBakour, Shagaf H.
dc.contributor.authorvan den Bosch, Thierry
dc.contributor.authorvan Doorn, Helena C.
dc.contributor.authorCameron, Sharon T.
dc.contributor.authorGiusa, Maria Gabriella [UNIFESP]
dc.contributor.authorDessole, Stefzano
dc.contributor.authorDijkhuizen, F. Paul H. L. J.
dc.contributor.authorter Riet, Gerben
dc.contributor.authorMol, Ben W. J.
dc.contributor.institutionUniv Amsterdam
dc.contributor.institutionBirmingham Womens Hlth Care NHS Trust
dc.contributor.institutionUniv Zurich
dc.contributor.institutionUniv Lund Hosp
dc.contributor.institutionSandwell & W Birmingham Hosp NHS Trust
dc.contributor.institutionUniv Hosp Leuven
dc.contributor.institutionErasmus MC
dc.contributor.institutionUniv Edinburgh
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionUniv Sassari
dc.contributor.institutionRijnstate Hosp
dc.date.accessioned2016-01-24T13:59:49Z
dc.date.available2016-01-24T13:59:49Z
dc.date.issued2010-07-01
dc.description.abstractOBJECTIVE: To estimate the accuracy of endometrial thickness measurement in the detection of endometrial cancer among women with postmenopausal bleeding with individual patient data using different meta-analytic strategies.DATA SOURCES: Original data sets of studies detected after reviewing the included studies of three previous reviews on this subject. An additional literature search of published articles using MEDLINE databases was preformed from January 2000 to December 2006 to identify articles reporting on endometrial carcinoma and sonographic endometrial thickness measurement in women with postmenopausal bleeding.METHODS of STUDY SELECTION: We identified 90 studies reporting on endometrial thickness measurements and endometrial carcinoma in women with postmenopausal bleeding.TABULATION, INTEGRATION, and RESULTS: We contacted 79 primary investigators to obtain the individual patient data of their reported studies, of which 13 could provide data. Data on 2,896 patients, of which 259 had carcinoma, were included. Several approaches were used in the analyses of the acquired data. First, we performed receiver operator characteristics (ROC) analysis per study, resulting in a summary area under the ROC curve (AUC) calculated as a weighted mean of AUCs from original studies. Second, individual patient data were pooled and analyzed with ROC analyses irrespective of study with standardization of distributional differences across studies using multiples of the median and by random effects logistic regression. Finally, we also used a two-stage procedure, calculating sensitivities and specificities for each study and using the bivariate random effects model to estimate summary estimates for diagnostic accuracy. This resulted in rather comparable ROC curves with AUCs varying between 0.82 and 0.84 and summary estimates for sensitivity and specificity located along these curves. These curves indicated a lower AUC than previously reported meta-analyses using conventional techniques.CONCLUSION: Previous meta-analyses on endometrial thickness measurement probably have overestimated its diagnostic accuracy in the detection of endometrial carcinoma. We advise the use of cutoff level of 3 mm for exclusion of endometrial carcinoma in women with postmenopausal bleeding. (Obstet Gynecol 2010;116:160-7)en
dc.description.affiliationUniv Amsterdam, Acad Med Ctr, Dept Obstet & Gynecol, NL-1105 AZ Amsterdam, Netherlands
dc.description.affiliationUniv Amsterdam, Acad Med Ctr, Dept Clin Epidemiol & Biostat, NL-1105 AZ Amsterdam, Netherlands
dc.description.affiliationBirmingham Womens Hlth Care NHS Trust, Dept Obstet & Gynecol, Birmingham, W Midlands, England
dc.description.affiliationUniv Zurich, Horten Ctr, Zurich, Switzerland
dc.description.affiliationUniv Lund Hosp, Dept Obstet & Gynecol, S-22185 Lund, Sweden
dc.description.affiliationSandwell & W Birmingham Hosp NHS Trust, Dept Obstet & Gynecol, Birmingham, W Midlands, England
dc.description.affiliationUniv Hosp Leuven, Dept Obstet & Gynecol, Leuven, Belgium
dc.description.affiliationErasmus MC, Dept Obstet & Gynecol, Rotterdam, Netherlands
dc.description.affiliationUniv Edinburgh, Dept Reprod & Dev Sci, Edinburgh, Midlothian, Scotland
dc.description.affiliationUniversidade Federal de São Paulo, Dept Gynecol, Escola Paulista Med, São Paulo, Brazil
dc.description.affiliationUniv Sassari, Dept Gynecol, I-07100 Sassari, Italy
dc.description.affiliationRijnstate Hosp, Dept Obstet & Gynecol, Arnhem, Netherlands
dc.description.affiliationUniv Amsterdam, Acad Med Ctr, Dept Gen Practice, NL-1105 AZ Amsterdam, Netherlands
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Dept Gynecol, Escola Paulista Med, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent160-167
dc.identifierhttp://dx.doi.org/10.1097/AOG.0b013e3181e3e7e8
dc.identifier.citationObstetrics and Gynecology. Philadelphia: Lippincott Williams & Wilkins, v. 116, n. 1, p. 160-167, 2010.
dc.identifier.doi10.1097/AOG.0b013e3181e3e7e8
dc.identifier.issn0029-7844
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/32643
dc.identifier.wosWOS:000278998600025
dc.language.isoeng
dc.publisherLippincott Williams & Wilkins
dc.relation.ispartofObstetrics and Gynecology
dc.rightsAcesso restrito
dc.titleEndometrial Thickness Measurement for Detecting Endometrial Cancer in Women With Postmenopausal Bleeding A Systematic Review and Meta-Analysisen
dc.typeResenha
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