Perceptions of women on the impact of menorrhagia on their health using multi‐attribute utility assessment

Abstract

Objective To assess patient preferences regarding the treatment of menorrhagia using the multiattribute utility methodologies, to produce a clinically applicable scale, and to assess health outcomes following treatment of menorrhagia. Methods Women referred to the gynaecology department for the treatment of menorrhagia were interviewed regarding the effects of menorrhagia on different aspects of their life. Their concerns were categorised into main components of health (domains). The relative importance of each domain was rated by the women using importance points which were distributed to represent the perceived importance of each domain. A series of statements (intra-domain statements) was developed for each domain, which described various possible conditions of that component of health. These were also rated using a one metre visual analogue scale with numerical anchor points at zero (worst) and 100 (best). Results The components of health considered most important were, in order of impact, family life, followed by physical health, work life, psychological health, practical difficulties and social life. The scores for the intra-domain statements were combined into a scale to allow the calculation of a final health state utility for a particular outcome based upon the statements the patient chooses within each domain. In planning treatment for menorrhagia clinicians can assess a woman's current perception of their health, using a simple to administer clinical scale.

Patient satisfaction and amenorrhea rate after endometrial ablation by ThermaChoice III or NovaSure: a retrospective cohort study

“…The questionnaire included questions about the consequences of HMB in six different domains: practical difficulties, social life, psychological health, physical health and well-being, work/daily routine, and family life/relationships. The sum of these domains gives a score between 0 (severely affected) and 100 (not affected) [11]. The condition-specific MMAS has a high face validity, good convergent, and discriminant validity and testretest reliability with high internal consistency [12].…”

The Effectiveness of Levonorgestrel-Releasing Intrauterine System in the Treatment of Heavy Menstrual Bleeding

“…Summary scores, which range from 0 (severely affected) to 100 (not affected), were assessed at 3, 6, 12 and 24 months. The MMAS has a high degree of reliability and internal consistency [11], has good content and construct validity [11,12], is responsive [13,14] and is acceptable to respondents [10,11,13,14].…”

“…The primary outcome measure was the condition-specific Menorrhagia Multi-Attribute Scale (MMAS) [10,11], which is designed to measure the effect of menorrhagia on six domains of daily life (practical difficulties, social life, psychological health, physical health, work and daily routine, and family life and relationships). Summary scores, which range from 0 (severely affected) to 100 (not affected), were assessed at 3, 6, 12 and 24 months.…”

Outpatient versus day-case endometrial ablation using the NovaSure™ impedance-controlled ablative system

“…Patients were asked to answer "yes" or "no" as to whether they were satisfied with their treatment. Secondary outcome measures included the measurement of health-related quality of life (HRQL) using the validated menorrhagia multi-attribute utility assessment [14], improvement in menstrual-related symptoms (dysmenorrhoea and pre-menstrual syndrome) and complications of surgery. Economic data were also collected and these included the time taken to resume normal activities and work, the number of post-procedure hospital outpatient and general practitioner visits and the need for further surgery for HMB.…”