Systematic review highlights difficulty interpreting diverse clinical outcomes in abnormal uterine bleeding trials

David D. Rahn, Husam Abed, Vivian W. Sung, Kristen A. Matteson, Rebecca G. Rogers, Michelle Y. Morrill, Matthew D. Barber, Joseph I. Schaffer, Thomas L. Wheeler, Ethan M. Balk, Katrin Uhlig

Research output: Contribution to journalArticlepeer-review

40 Scopus citations


Objectives: (1) To systematically collect and organize into clinical categories all outcomes reported in trials for abnormal uterine bleeding (AUB); (2) to rank the importance of outcomes for patient decision making; and (3) to improve future comparisons of effects in trials of AUB interventions. Study Design and Setting: Systematic review of English-language randomized controlled trials of AUB treatments in MEDLINE from 1950 to June 2008. All outcomes and definitions were extracted and organized into major outcome categories by an expert group. Each outcome was ranked "critically important," "important," or "not important" for informing patients' choices. Results: One hundred thirteen articles from 79 trials met the criteria. One hundred fourteen different outcomes were identified, only 15 (13%) of which were ranked as critically important and 29 (25%) as important. Outcomes were grouped into eight categories: (1) bleeding; (2) quality of life; (3) pain; (4) sexual health; (5) patient satisfaction; (6) bulk-related complaints; (7) need for subsequent surgical treatment; and (8) adverse events. Conclusion: To improve the quality, consistency, and utility of future AUB trials, we recommend assessing a limited number of clinical outcomes for bleeding, disease-specific quality of life, pain, sexual health, and bulk-related symptoms both before and after treatment and reporting satisfaction and adverse events. Further development of validated patient-based outcome measures and the standardization of outcome reporting are needed.

Original languageEnglish (US)
Pages (from-to)293-300
Number of pages8
JournalJournal of Clinical Epidemiology
Issue number3
StatePublished - Mar 2011


  • Dysfunctional uterine bleeding
  • Endometrial ablation
  • Hysterectomy
  • Leiomyomata
  • Menorrhagia
  • Uterine artery embolization

ASJC Scopus subject areas

  • Epidemiology


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