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Health-related quality of life measurement in women with common benign gynecologic conditions: A systematic review

      Abstract

      Endometriosis, menorrhagia, chronic pelvic pain, and polycystic ovary syndrome are major sources of psychologic morbidity and can negatively affect quality of life. Although comparative studies have been published on the measurement of health-related quality of life for gynecologic malignancies, a similar review for these benign gynecologic conditions has not been conducted. Consequently, we searched the literature systematically to identify the impact of symptoms and treatments for these conditions on health status and to report on the types and psychometric properties of the instruments used. Papers were retrieved by systematically searching 6 electronic databases and hand-searching relevant reference lists and bibliographies. Forty-six studies used a questionnaire to measure health status: 34 studies (74%) used standardized instruments; of these, 23 studies (68%) used generic tools. Although a meta analysis was not possible, it appears that women with chronic pelvic pain and conditions that are associated with pelvic pain (such as endometriosis) report worse health-related quality of life. Despite the development of disease-specific questionnaires, only 2 questionnaires were generated from interviews of patients with the condition of interest, and few questionnaires are being used to evaluate the outcomes of treatment on subjective health status. (Am J Obstet Gynecol 2002;187:501-11.)

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      References

        • Colwell H
        • Mathias SD
        • Pasta DJ
        • Henning JM
        • Steege JF
        A health-related quality of life instrument for symptomatic patients with endometriosis: a validation study.
        Am J Obstet Gynecol. 1998; 179: 47-55
        • Mant D
        • Fowler G
        Mass screening: theory and ethics.
        Br Med J. 1990; 300: 916-918
        • Anderson B
        • Lutgendorf S
        Quality of life in gynecologic cancer survivors.
        CA Cancer J Clin. 1997; 47: 218-225
        • Anderson B
        • Lutgendorf S
        Quality of life as an outcome measure in gynecologic malignancies.
        Curr Opin Obstet Gynecol. 2000; 12: 21-26
        • McCartney CF
        • Larson DB
        Quality of life in patients with gynecologic cancer.
        Cancer. 1987; 60: 2129-2136
        • Mele V
        • Palazzani L
        • Sgreccia E
        Quality of life in gynaecological oncology.
        Eur J Gynaecol Oncol. 1992; S1: 89-91
        • Montazeri A
        • McEwen J
        • Gillis CR
        Quality of life in patients with ovarian cancer: current state of research.
        Support Care Cancer. 1996; 4: 169-179
        • Fish LS
        • Lewis BE
        Quality of life issues in the management of ovarian cancer.
        Semin Oncol. 1999; 26: 32-39
        • Anderson B
        Quality of life in progressive ovarian cancer.
        Gynecol Oncol. 1994; 55: S151-S155
        • Ersek M
        • Ferrell BR
        • Dow KH
        • Melancon CH
        Quality of life in women with ovarian cancer.
        West J Nurs Res. 1997; 19: 334-350
        • Schover LR
        Quality counts: the value of women's perceived quality of life after cervical cancer.
        Gynecol Oncol. 1999; 76: 3-4
        • Anderson B
        Stress and quality of life following cervical cancer.
        J Natl Cancer Inst. 1996; 21: 65-70
        • Weinstein K
        The emotional aspects of endometriosis: what the patient expects from her doctor.
        Clin Obstet Gynecol. 1988; 31: 866-873
        • Jones KP
        The emotional aspects of endometriosis: a physicians perspective.
        Clin Obstet Gynecol. 1988; 31: 874-882
        • Low WY
        • Edelmann RJ
        Psychosocial aspects of endometriosis: a review.
        J Psychosom Obstet Gynaecol. 1990; 12: 3-12
        • Walker E
        • Katon W
        • Jones LM
        • Russo J
        Relationship between endometriosis and affective disorder.
        Am J Psychiatry. 1989; 146: 380-381
        • Lewis DO
        • Comite F
        • Mallouh C
        • Zadunaisky L
        • Hutchinson-Williams K
        • Cherksey BD
        • et al.
        Bipolar mood disorder and endometriosis: preliminary findings.
        Am J Psychiatry. 1987; 144: 1588-1591
        • Low YL
        • Edelmann RJ
        • Sutton C
        A psychological profile of endometriosis patients in comparison to patients with pelvic pain of other origins.
        J Psychosom Res. 1993; 37: 111-116
        • Peveler R
        • Edwards J
        • Daddow J
        • Thomas E
        Psychosocial factors and chronic pelvic pain: a comparison of women with endometriosis and with unexplained pain.
        J Psychosom Res. 1996; 40: 305-315
        • Waller K
        • Shaw R
        Endometriosis, pelvic pain, and psychological functioning.
        Fertil Steril. 1995; 63: 796-800
        • Collier JAB
        • Longmore JM
        • Hodgetts TJ
        Oxford handbook of clinical specialties.
        : Oxford University Press, Oxford1995
        • Sonino N
        • Fava GA
        • Mani E
        • Belluardo P
        • Boscaro M
        Quality of life of hirsute women.
        Postgrad Med J. 1993; 69: 186-189
        • Jamieson DJ
        • Steege JF
        The prevalence of dysmenorrhea, dyspareunia, pelvic pain and irritable bowel syndrome in primary practices.
        Obstet Gynecol. 1996; 87: 55-59
        • Velikova G
        • Stark D
        • Selby P
        Quality of life instruments in oncology.
        Eur J Cancer. 1999; 35: 1571-1580
        • Kline P
        A handbook of test construction.
        : Methuen, London1986
        • Fitzpatrick R
        • Davey C
        • Buxton M
        • Jones DR
        Patient-assessed outcome measures.
        in: Health services research methods. : BMJ Publications, London1998: 13-22
        • Fallowfield LJ
        Quality of life measurement in breast cancer.
        J R Soc Med. 1993; 86: 10-12
        • Rock JA
        • Roberts CP
        Management of pelvic pain recurrence: a quality of life issue in endometriosis.
        J Gynecol Tech. 1999; 5: 567-578
        • Damario MA
        • Rock JA
        Pain recurrence: a quality of life issue in endometriosis.
        Int J Gynaecol Obstet. 1995; 50: S27-S42
        • Naughton MJ
        • McBee WL
        Health-related quality of life after hysterectomy.
        Clin Obstet Gynecol. 1997; 40: 947-957
        • Hidlebaugh DA
        Cost and quality-of-life issues associated with different surgical therapies for the treatment of abnormal uterine bleeding.
        Obstet Gynecol Clin North Am. 2000; 27: 451-465
        • Kadir RA
        • Sabin CA
        • Pollard D
        • Lee CA
        • Economides DL
        Quality of life during menstruation in patients with inherited bleeding disorders.
        Haemophilia. 1998; 4: 836-841
        • Stones RW
        • Selfe SA
        • Fransman S
        • Horn SA
        Psychosocial and economic impact of chronic pelvic pain.
        Bailleres Clin Obstet Gynaecol. 2000; 14: 415-431
        • Zhao SZ
        • Kellerman LA
        • Francisco CA
        • Wong JM
        Impact of nafarelin and leuprolide for endometriosis on quality of life and subjective clinical measures.
        J Reprod Med. 1999; 44: 1000-1006
        • Regidor PA
        • Regidor M
        • Kato K
        • Bier UW
        • Buhler K
        • Schindler AE
        Long-term follow up on the treatment of endometriosis with the GnRH-agonist buserelin acetate. Long-term follow up data (up to 98 months) of 42 patients with endometriosis who were treated with GnRH-agonist buserelin acetate (Suprecur), were evaluated in respect of recurrence of pain symptoms and pregnancy outcome.
        Eur J Obstet Gynecol Reprod Biol. 1997; 73: 153-160
        • Meyer WR
        • Walsh BW
        • Grainger DA
        • Peacock LM
        • Loffer FD
        • Steege JF
        Thermal balloon and rollerball ablation to treat menorrhagia: a multicenter comparison.
        Obstet Gynecol. 1998; 92: 98-103
        • El Senoun GSA
        • Mousa HA
        • Mahmood TA
        Medium-term follow-up of women with menorrhagia treated by rollerball endometrial ablation.
        Acta Obstet Gynecol Scand. 2000; 79: 879-883
        • Preston JT
        • Cameron IT
        • Adams EJ
        • Smith SK
        Comparative study of tranexamic acid and norethisterone in the treatment of ovulatory menorrhagia.
        Br J Obstet Gynaecol. 1995; 102: 401-406
        • Roberts RN
        • Norman BP
        • Harrison CG
        • Heaton NR
        • Law JK
        • Wadehra V
        • et al.
        A medical audit and patient survey of hysterectomies performed for menstrual disorders.
        Scott Med J. 1996; 41: 44-46
        • Still RM
        • Walsh DJ
        A pilot study to assess the learning curve in transcervical endometrial resection: possible implications for postgraduate accreditation.
        Gynaecol Endoscopy. 1992; 1: 111-113
        • Doyle DF
        • Li TC
        • Richmond MN
        The prevalence of continuing chronic pelvic pain following a negative laparoscopy.
        J Obstet Gynaecol. 1998; 18: 252-255
        • Dwyer N
        • Stirratt GM
        Randomised controlled trial comparing endometrial resection with abdominal hysterectomy for the surgical treatment of menorrhagia.
        Br J Obstet Gynaecol. 1993; 100: 237-243
        • Panzeri M
        • Casadei D
        • Garozzo V
        • Fabbri M
        Hysterectomy: analysis of the effectiveness of psychological preparation for surgery on post operation quality of life.
        Ital J Gynaecol Obstet. 2000; 12: 54-60
        • Lahteenmaki P
        • Haukkamaa M
        • Puolakka J
        • Riikonen U
        • Sainio S
        • Suvisaari J
        • et al.
        Open randomised study of use of levonorgestrel releasing intrauterine system as alternative to hysterectomy.
        Br Med J. 1998; 316: 1122-1126
        • Kline P
        A psychometrics primer.
        : Free Association Books, London2000
        • Sandberg SI
        • Barnes BA
        • Weinstein MC
        • Braun P
        Elective hysterectomy: benefits, risks and costs.
        Med Care. 1985; 23: 1067-1085
        • Evans KD
        A cost utility analysis of sono-hysteroscopy compared with hysteroscopic evaluation for dysfunctional uterine bleeding.
        J Diagn Med Sonogr. 2000; 16: 68-72
        • Alexander DA
        • Naji AA
        • Pinion SB
        • Mollison J
        • Kitchener HC
        • Parkin DE
        • et al.
        Randomised trial comparing hysterotomy with endometrial ablation for dysfunctional uterine bleeding: psychiatric and psychosocial aspects.
        Br Med J. 1996; 312: 280-284
        • Crosignani PG
        • Vercellini P
        • Apolone G
        • De Giorgi O
        • Cortesi I
        • Meschia M
        Endometrial resection versus vaginal hysterectomy for menorrhagia: long term clinical and quality-of-life outcomes.
        Am J Obstet Gynecol. 1997; 177: 95-101
        • Kjerulff KH
        • Langenberg PW
        • Rhodes JC
        • Harvey LA
        • Guzinski GM
        • Stolleyy PD
        Effectiveness of hysterectomy.
        Obstet Gynecol. 2000; 95: 319-326
        • Carlson KJ
        • Miler BA
        • Fowler FJ
        The Maine Women's Health Study: I. Outcomes of hysterectomy.
        Obstet Gynecol. 1994; 83: 556-564
        • Carlson KJ
        • Miler BA
        • Fowler FJ
        The Maine Women's Health Study: II. Outcomes of non surgical management of leiomyomas, abnormal bleeding and chronic pelvic pain.
        Obstet Gynecol. 1994; 83: 566-572
        • Bodner C
        • Garratt AM
        • Ratcliffe J
        • Macdonald LM
        • Penney GC
        Measuring health-related quality of life outcomes in women with endometriosis: results of the gynaecology audit project in Scotland.
        Health Bull (Edinb). 1997; 55: 109-117
        • Burry KA
        Nafarelin in the management of endometriosis: quality of life assessment.
        Am J Obstet Gynecol. 1992; 166: 735-739
        • Miller JD
        Quantification of endometriosis-associated pain and quality of life during the stimulatory phase of gonadotropin-releasing hormone agonist therapy: a double-blind, randomized, placebo-controlled trial.
        Am J Obstet Gynecol. 2000; 182: 1483-1488
        • Garry R
        • Clayton R
        • Hawe J
        The effect of endometriosis and its radical laparoscopic excision on quality of life indicators.
        Br J Obstet Gynaecol. 2000; 107: 44-54
        • Shaw R
        • Brickley MR
        • Evans L
        • Edwards MJ
        Perceptions of women on the impact of menorrhagia on their health using multi-attribute utility assessment.
        Br J Obstet Gynaecol. 1998; 105: 1155-1159
        • Lamping DL
        • Rowe P
        • Clarke A
        • Black N
        • Lessof L
        Development and validation of the menorrhagia outcomes questionnaire.
        Br J Obstet Gynaecol. 1998; 105: 766-779
        • Ruta DA
        • Garratt AM
        • Russell IT
        Patient centered assessment of quality of life for patients with four common conditions.
        Quality in Health Care. 1999; 8: 22-29
        • Jenkinson C
        • Peto V
        • Coulter A
        Measuring change over time: a comparison of results from a global single item of health status and the multi-dimensional SF-36 health status survey questionnaire in patients presenting with menorrhagia.
        Qual Life Res. 1994; 3: 317-321
        • Garratt AM
        • Ruta DA
        • Abdalla MI
        • Buckingham JK
        • Russell IT
        The SF36 health survey questionnaire: an outcome measure suitable for routine use within the NHS.
        BMJ. 1993; 306: 1440-1444
        • Sculpher MJ
        • Bryan S
        • Dwyer N
        • Hutton J
        • Stirrat GM
        An economic evaluation of transcervical endometrial resection versus abdominal hysterectomy for the treatment of menorrhagia.
        Br J Obstet Gynaecol. 1993; 100: 244-252
        • Scialli AR
        • Levi AJ
        Intermittent leuprolide acetate for the nonsurgical management of women with leiomyomata uteri.
        Fertil Steril. 2000; 74: 540-546
        • Coulter A
        • Peto V
        • Jenkinson C
        Quality of life and patient satisfaction following treatment for menorrhagia.
        Fam Pract. 1994; 11: 394-401
        • Sculpher MJ
        • Dwyer N
        • Byford S
        • Stirrat GM
        Randomised trial comparing hysterectomy and transcervical endometrial resection: effect on health related quality of life and costs two years after surgery.
        Br J Obstet Gynaecol. 1996; 103: 142-149
        • Crosignani PG
        • Vercellini P
        • Mosconi P
        • Oldani S
        • Cortesi I
        • De-Giorgi O
        Levonorgestrel-releasing intrauterine device versus hysteroscopic endometrial resection in the treatment of dysfunctional uterine bleeding.
        Obstet Gynecol. 1997; 90: 257-263
        • Cooper KG
        • Bain C
        • Parkin DE
        Comparison of microwave endometrial ablation and transcervical resection of the endometrium for treatment of heavy menstrual loss: a randomised trial.
        Lancet. 1999; 354: 1859-1863
        • Cooper KG
        • Parkin DE
        • Garratt AM
        • Grant AM
        A randomised comparison of medical and hysteroscopic management in women consulting a gynaecologist for treatment of heavy menstrual loss.
        Br J Obstet Gynaecol. 1997; 104: 1360-1366
        • Cooper KG
        • Parkin DE
        • Garratt AM
        • Grant AM
        Two-year follow up of women randomised to medical management or transcervical resection of the endometrium for heavy menstrual loss: clinical and quality of life outcomes.
        Br J Obstet Gynaecol. 1999; 106: 258-265
        • Cooper KG
        • Grant AM
        • Garratt AM
        The impact of using a partially randomised patient preference design when evaluating alternative managements for heavy menstrual bleeding.
        Br J Obstet Gynaecol. 1997; 104: 1367-1373
        • Chadha Y
        • Mollison J
        • Howie F
        • Grimshaw J
        • Hall M
        • Russell I
        Guidelines in gynaecology: evaluation in menorrhagia and in urinary incontinence.
        Br J Obstet Gynaecol. 2000; 107: 535-543
        • Spies JB
        • Warren EH
        • Mathias SD
        • Walsh SM
        • Roth AR
        • Pentecost MJ
        Uterine fibroid embolization: measurement of health-related quality of life before and after therapy.
        J Vasc Interv Radiol. 1999; 10: 1293-1303
        • Cronin L
        • Guyatt G
        • Griffith E
        • Wong E
        • Azziz R
        • Futterweit W
        • et al.
        Development of a health-related quality-of-life questionnaire (PCOSQ) for women with polycystic ovary syndrome (PCOS).
        J Clin Endocrinol Metab. 1998; 83: 1976-1987
        • Mathias SD
        • Kuppermann M
        • Liberman R
        • Lipschutz RC
        • Steege JF
        Chronic pelvic pain: prevalence, health related quality of life, and economic correlates.
        Obstet Gynecol. 1996; 87: 321-327
        • Rowe MK
        • Kanouse DE
        • Mittman BS
        • Bernstein SJ
        Quality of life among women undergoing hysterectomies.
        Obstet Gynecol. 1999; 93: 915-921
        • Clarke A
        • Black N
        • Rowe P
        • Mott S
        • Howle K
        Indications for and outcome of total abdominal hysterectomy for benign disease: a prospective cohort study.
        Br J Obstet Gynaecol. 1995; 102: 611-620
        • Van Den Eeden SK
        • Glasser M
        • Mathias SD
        • Colwell HH
        • Pasta DJ
        • Kunz K
        Quality of life, health care utilization, and costs among women undergoing hysterectomy in a managed-care setting.
        Am J Obstet Gynecol. 1998; 178: 91-100
        • McPherson A
        • Anderson A
        The “ectomies.”.
        in: Women's problems in general practice. : Oxford University Press, Oxford1987: 112-121
        • Jenkinson C
        Assessment and evaluation of health and medical care: a methods text.
        : Open University Press, Buckingham1997
        • Streiner DL
        Health measurement scales: a practical guide to their development and use.
        2nd ed. : Oxford University Press, Oxford1995
        • Woodend AK
        • Nair RC
        • Tang AS
        Definition of life quality from a patient versus health care professional perspective.
        Int J Rehabil Res. 1997; 20: 71-80
        • Present CA
        Quality of life in cancer patients: Who measures what?.
        Am J Clin Oncol. 1991; 7: 571-573
        • Slevin ML
        • Plant H
        • Lynch D
        • Drinkwater J
        • Gregory WM
        Who should measure quality of life, the doctor or the patient?.
        Br J Cancer. 1988; 57: 109-112
        • Patrick DL
        • Bergner M
        Measurement of health status in the 1990s.
        Annu Rev Public Health. 1990; 11: 165-183
        • Fitzpatrick R
        • Ziebland S
        • Jenkinson C
        • Mowat A
        A comparison of the sensitivity to change of several health status instruments in rheumatoid arthritis.
        J Rheumatol. 1993; 20: 429-436
        • Parkerson GR
        • Connis RT
        • Broadhead WE
        • Patrick DL
        • Taylor TR
        • Tse CK
        Disease-specific versus generic measurement of health-related quality of life in insulin-dependent diabetic patients.
        Med Care. 1993; 31: 629-639