Randomised trial of an integrated educational strategy to reduce investigation rates in young women with dysfunctional uterine bleeding
ABSTRACT Objectives To assess the effectiveness of an integrated educational strategy to change clinician behaviour and reduce the number of hysteroscopies and/or dilatation and curettages for women 40 years or less with dysfunctional uterine bleeding (DUB). Design Randomised controlled trial with s...
Saved in:
| Published in | Australian & New Zealand journal of obstetrics & gynaecology Vol. 42; no. 4; pp. 397 - 402 |
|---|---|
| Main Authors | , , , |
| Format | Journal Article |
| Language | English |
| Published |
Oxford, UK
Blackwell Publishing Ltd
01.10.2002
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 0004-8666 1479-828X |
| DOI | 10.1111/j.0004-8666.2002.00397.x |
Cover
| Abstract | ABSTRACT
Objectives
To assess the effectiveness of an integrated educational strategy to change clinician behaviour and reduce the number of hysteroscopies and/or dilatation and curettages for women 40 years or less with dysfunctional uterine bleeding (DUB).
Design
Randomised controlled trial with six‐month followup.
Setting
Public teaching hospital gynaecology units with 12,000‐13,000 relevant procedures per year.
Participants
Six public gynaecology units made up of 62 gynaecologists or trainees allocated at random to intervention group ‐ three, or control group ‐ 3.
Intervention
An educational strategy that included dissemination of evidence‐based guidelines via a problembased interactive workshop facilitated by an opinion leader and a laminated algorithm and guidelines.
Main outcome measures
The number of hysteroscopies and/or dilatation and curettages performed for DUB on women 40 years or less, clinician behaviour change and perceived booking rates of the procedure.
Results
At six months, there was no significant effect on the number of hysteroscopies and/or dilatation and curettages performed but there was an increase in evidence‐based behaviour. |
|---|---|
| AbstractList | ABSTRACT
Objectives
To assess the effectiveness of an integrated educational strategy to change clinician behaviour and reduce the number of hysteroscopies and/or dilatation and curettages for women 40 years or less with dysfunctional uterine bleeding (DUB).
Design
Randomised controlled trial with six‐month followup.
Setting
Public teaching hospital gynaecology units with 12,000‐13,000 relevant procedures per year.
Participants
Six public gynaecology units made up of 62 gynaecologists or trainees allocated at random to intervention group ‐ three, or control group ‐ 3.
Intervention
An educational strategy that included dissemination of evidence‐based guidelines via a problembased interactive workshop facilitated by an opinion leader and a laminated algorithm and guidelines.
Main outcome measures
The number of hysteroscopies and/or dilatation and curettages performed for DUB on women 40 years or less, clinician behaviour change and perceived booking rates of the procedure.
Results
At six months, there was no significant effect on the number of hysteroscopies and/or dilatation and curettages performed but there was an increase in evidence‐based behaviour. To assess the effectiveness of an integrated educational strategy to change clinician behaviour and reduce the number of hysteroscopies and/or dilatation and curettages for women 40 years or less with dysfunctional uterine bleeding (DUB). Randomised controlled trial with six-month follow-up. Public teaching hospital gynaecology units with 12,000-13,000 relevant procedures per year. Six public gynaecology units made up of 62 gynaecologists or trainees allocated at random to intervention group - three, or control group - 3. Intervention An educational strategy that included dissemination of evidence-based guidelines via a problem-based interactive workshop facilitated by an opinion leader and a laminated algorithm and guidelines. The number of hysteroscopies and/or dilatation and curettages performed for DUB on women 40 years or less, clinician behaviour change and perceived booking rates of the procedure. At six months, there was no significant effect on the number of hysteroscopies and/or dilatation and curettages performed but there was an increase in evidence-based behaviour. While the evidence-based educational strategy for the appropriate investigation of young women with DUB resulted in clinician behaviour change when applied to theoretical cases, it did not result in a reduction in hysteroscopy/D&C rates at six months. To assess the effectiveness of an integrated educational strategy to change clinician behaviour and reduce the number of hysteroscopies and/or dilatation and curettages for women 40 years or less with dysfunctional uterine bleeding (DUB).OBJECTIVESTo assess the effectiveness of an integrated educational strategy to change clinician behaviour and reduce the number of hysteroscopies and/or dilatation and curettages for women 40 years or less with dysfunctional uterine bleeding (DUB).Randomised controlled trial with six-month follow-up.DESIGNRandomised controlled trial with six-month follow-up.Public teaching hospital gynaecology units with 12,000-13,000 relevant procedures per year.SETTINGPublic teaching hospital gynaecology units with 12,000-13,000 relevant procedures per year.Six public gynaecology units made up of 62 gynaecologists or trainees allocated at random to intervention group - three, or control group - 3. Intervention An educational strategy that included dissemination of evidence-based guidelines via a problem-based interactive workshop facilitated by an opinion leader and a laminated algorithm and guidelines.PARTICIPANTSSix public gynaecology units made up of 62 gynaecologists or trainees allocated at random to intervention group - three, or control group - 3. Intervention An educational strategy that included dissemination of evidence-based guidelines via a problem-based interactive workshop facilitated by an opinion leader and a laminated algorithm and guidelines.The number of hysteroscopies and/or dilatation and curettages performed for DUB on women 40 years or less, clinician behaviour change and perceived booking rates of the procedure.MAIN OUTCOME MEASURESThe number of hysteroscopies and/or dilatation and curettages performed for DUB on women 40 years or less, clinician behaviour change and perceived booking rates of the procedure.At six months, there was no significant effect on the number of hysteroscopies and/or dilatation and curettages performed but there was an increase in evidence-based behaviour.RESULTSAt six months, there was no significant effect on the number of hysteroscopies and/or dilatation and curettages performed but there was an increase in evidence-based behaviour.While the evidence-based educational strategy for the appropriate investigation of young women with DUB resulted in clinician behaviour change when applied to theoretical cases, it did not result in a reduction in hysteroscopy/D&C rates at six months.CONCLUSIONSWhile the evidence-based educational strategy for the appropriate investigation of young women with DUB resulted in clinician behaviour change when applied to theoretical cases, it did not result in a reduction in hysteroscopy/D&C rates at six months. |
| Author | Grover, Sonia Santin, Anita Searle, Judith Weideman, Prue |
| Author_xml | – sequence: 1 givenname: Judith surname: Searle fullname: Searle, Judith organization: Royal Women's Hospital, Carlton, Victoria, Australia – sequence: 2 givenname: Sonia surname: Grover fullname: Grover, Sonia organization: Royal Women's Hospital, Carlton, Victoria, Australia – sequence: 3 givenname: Anita surname: Santin fullname: Santin, Anita organization: Flinders University of South Australia, Bedford Park, South Australia, Australia – sequence: 4 givenname: Prue surname: Weideman fullname: Weideman, Prue organization: Royal Women's Hospital, Carlton, Victoria, Australia |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/12403289$$D View this record in MEDLINE/PubMed |
| BookMark | eNqNkdFu0zAUhi00xLrBKyBfcZdiO06cSAhpTKwDJiYQiIkby3FOiktqD9uhzRPw2jht6QU3kBvH53z_b_v8Z-jEOgsIYUrmNH3PV3NCCM-qsiznjBCWtnkt5tsHaEa5qLOKVXcnaHaETtFZCCtCaF1Q_gidUsZJzqp6hn59VLZ1axOgxdEb1WPXYWWxsRGWXsVUhnbQKhpnUzPEqbYccXTYTw1I5E8I0Sx3CJ7aIdXw6Aa7xBu3Bos3Jn7D7Ri6weqD0RDBGwu46QFaY5eP0cNO9QGeHNZz9Pnq9afL6-zmdvHm8uIm03nORUZ5C3WhdK0ayjqaA2ONZlTxsm4rxqqC1wKqqlSKiqLhDIpC6LprOTBddVDk5-jZ3vfeux9DurhMb9fQ98qCG4IUrKQ142UCnx7AoVlDK--9WSs_yj-jS8DLPaC9C8FDJ7WJuyGkGZleUiKnrORKTjHIKQY5ZSV3WcltMqj-Mjie8W_pi710Y3oY_1snL97epp8kz_ZyEyJsj3Llv8tS5KKQX94v5Kvru6_vFh-upMh_A2yzvcg |
| CitedBy_id | crossref_primary_10_1111_j_0013_9580_2004_24003_x crossref_primary_10_1002_14651858_CD003030_pub3 crossref_primary_10_1002_14651858_CD000125_pub4 crossref_primary_10_1002_14651858_CD000125_pub5 |
| Cites_doi | 10.1136/bmj.317.7152.200 10.1016/0002-9378(87)90285-7 10.1111/j.1471-0528.1991.tb13484.x 10.1016/0090-8258(85)90211-2 10.1056/NEJM198911093211906 10.1001/jama.1995.03530090032018 10.1093/humrep/12.9.2041 10.1001/jama.1991.03460170056033 10.1136/bmj.317.7165.1041 10.1111/j.1471-0528.2000.tb13275.x 10.1136/bmj.318.7193.1246 10.1001/jama.1992.03490090053014 10.1006/pmed.1996.0114 10.1136/bmj.307.6911.1045 10.1016/S0140-6736(88)90943-9 10.1097/00005650-198901000-00002 10.1016/0029-7844(96)00108-1 10.1136/bmj.317.7156.465 10.1136/bmj.308.6942.1488 10.1111/j.1471-0528.1989.tb02433.x 10.3109/00016349709047787 10.1016/S0002-9378(99)70487-4 |
| ContentType | Journal Article |
| DBID | BSCLL AAYXX CITATION CGR CUY CVF ECM EIF NPM 7X8 |
| DOI | 10.1111/j.0004-8666.2002.00397.x |
| DatabaseName | Istex CrossRef Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed MEDLINE - Academic |
| DatabaseTitle | CrossRef MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) MEDLINE - Academic |
| DatabaseTitleList | MEDLINE MEDLINE - Academic |
| Database_xml | – sequence: 1 dbid: NPM name: PubMed url: https://proxy.k.utb.cz/login?url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: EIF name: MEDLINE url: https://proxy.k.utb.cz/login?url=https://www.webofscience.com/wos/medline/basic-search sourceTypes: Index Database |
| DeliveryMethod | fulltext_linktorsrc |
| Discipline | Medicine |
| EISSN | 1479-828X |
| EndPage | 402 |
| ExternalDocumentID | 12403289 10_1111_j_0004_8666_2002_00397_x AJO397 ark_67375_WNG_BHXZKGQF_7 |
| Genre | article Clinical Trial Randomized Controlled Trial Research Support, Non-U.S. Gov't Journal Article |
| GroupedDBID | --- .3N .GA .GJ .Y3 05W 0R~ 10A 1OB 1OC 23N 31~ 33P 36B 3SF 4.4 50Y 50Z 51W 51X 52M 52N 52O 52P 52R 52S 52T 52U 52V 52W 52X 53G 5GY 5HH 5LA 5RE 5VS 66C 6PF 702 7PT 8-0 8-1 8-3 8-4 8-5 8UM 930 A01 A03 AAESR AAEVG AAHQN AAIPD AAMMB AAMNL AANHP AANLZ AAONW AASGY AAWTL AAXRX AAYCA AAZKR ABCQN ABCUV ABEML ABJNI ABQWH ABXGK ACAHQ ACBWZ ACCZN ACGFS ACGOF ACMXC ACPOU ACRPL ACSCC ACXBN ACXQS ACYXJ ADBBV ADBTR ADEOM ADIZJ ADKYN ADMGS ADNMO ADOZA ADZMN AEFGJ AEIGN AEIMD AENEX AEUYR AEYWJ AFBPY AFEBI AFFNX AFFPM AFGKR AFWVQ AFZJQ AGHNM AGQPQ AGXDD AGYGG AHBTC AHEFC AIACR AIDQK AIDYY AIQQE AITYG AIURR ALAGY ALMA_UNASSIGNED_HOLDINGS ALUQN ALVPJ AMBMR AMYDB ASPBG ATUGU AVWKF AZBYB AZFZN AZVAB BAFTC BDRZF BFHJK BHBCM BMXJE BROTX BRXPI BSCLL BY8 C45 CAG COF D-6 D-7 D-E D-F DCZOG DPXWK DR2 DRFUL DRMAN DRSTM DUUFO EBS EJD EMOBN EX3 F00 F01 F04 F5P FEDTE FUBAC G-S G.N GODZA H.X HF~ HGLYW HVGLF HZI HZ~ IHE IX1 J0M K48 KBYEO LATKE LC2 LC3 LEEKS LH4 LITHE LOXES LP6 LP7 LUTES LW6 LYRES MEWTI MK4 MRFUL MRMAN MRSTM MSFUL MSMAN MSSTM MXFUL MXMAN MXSTM N04 N05 NF~ O66 O9- OIG OVD P2P P2W P2X P2Z P4B P4D PALCI Q.N Q11 QB0 R.K RIWAO RJQFR ROL RX1 SAMSI SUPJJ TEORI UB1 W8V W99 WBKPD WHWMO WIH WIJ WIK WOHZO WOW WQJ WVDHM WXI WXSBR XG1 ZGI ZZTAW ~IA ~WT AAHHS ACCFJ ADZOD AEEZP AEQDE AIWBW AJBDE AAYXX CITATION AEUQT AFPWT CGR CUY CVF ECM EIF ESX NPM WRC WUP 7X8 |
| ID | FETCH-LOGICAL-c3347-14de95ac9ab12f13e22bc21a469d82285497e886aa175b42e557c9fd4e2c8fe53 |
| IEDL.DBID | DR2 |
| ISSN | 0004-8666 |
| IngestDate | Fri Sep 05 07:55:37 EDT 2025 Wed Feb 19 02:34:42 EST 2025 Thu Apr 24 23:11:01 EDT 2025 Wed Oct 01 03:07:05 EDT 2025 Wed Apr 02 05:42:47 EDT 2025 Sun Sep 21 06:18:52 EDT 2025 |
| IsPeerReviewed | true |
| IsScholarly | true |
| Issue | 4 |
| Language | English |
| LinkModel | DirectLink |
| MergedId | FETCHMERGED-LOGICAL-c3347-14de95ac9ab12f13e22bc21a469d82285497e886aa175b42e557c9fd4e2c8fe53 |
| Notes | istex:2FF298F58109F5F8560EA73FD9073C4BDF65D910 ark:/67375/WNG-BHXZKGQF-7 ArticleID:AJO397 Judith Searle BM BS FRANZCOG GDPH MD GCTE Senior Lecturer in Obstetrics and Gynaecology, Sonia Grover MD FRANZCOG Consultant Obstetrician and Gynaecologist, Anita Santin BA Research Assistant, Prue Weideman, RN Grad Dip Health Ed Promotion Research Assistant ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 ObjectType-Undefined-3 |
| PMID | 12403289 |
| PQID | 72619246 |
| PQPubID | 23479 |
| PageCount | 6 |
| ParticipantIDs | proquest_miscellaneous_72619246 pubmed_primary_12403289 crossref_citationtrail_10_1111_j_0004_8666_2002_00397_x crossref_primary_10_1111_j_0004_8666_2002_00397_x wiley_primary_10_1111_j_0004_8666_2002_00397_x_AJO397 istex_primary_ark_67375_WNG_BHXZKGQF_7 |
| ProviderPackageCode | CITATION AAYXX |
| PublicationCentury | 2000 |
| PublicationDate | 2002-10-01 |
| PublicationDateYYYYMMDD | 2002-10-01 |
| PublicationDate_xml | – month: 10 year: 2002 text: 2002-10-01 day: 01 |
| PublicationDecade | 2000 |
| PublicationPlace | Oxford, UK |
| PublicationPlace_xml | – name: Oxford, UK – name: Australia |
| PublicationTitle | Australian & New Zealand journal of obstetrics & gynaecology |
| PublicationTitleAlternate | Aust N Z J Obstet Gynaecol |
| PublicationYear | 2002 |
| Publisher | Blackwell Publishing Ltd |
| Publisher_xml | – name: Blackwell Publishing Ltd |
| References | Chadha Y, Mollison J, Howie F, Grimshaw J, Hall M, Russell I. Guidelines in gynaecology; evaluation in menorrhagia and in urinary incontinence. BJOG. 2000 Apr; 107 (4): 535-543. Bath PM, Prasad A, Brown MM, MacGregor GA. Survey of use of anticoagulation in patients with atrial fibrillation. BMJ. 1993 Oct 23; 307 (6911): 1045. Penney G, Vale L, Souter V, Templeton A. Endometrial assessment procedures: an audit of current practice in Scotland. Hum Reprod. 1997 Sep; 12 (9): 2041-2045.DOI: 10.1093/humrep/12.9.2041 Davis DA, Thomson MA, Oxman AD, Haynes RB. Changing physician performance. A systematic review of the effect of continuing medical education strategies. JAMA. 1995 Sep 6; 274 (9): 700-705. Coulter A, Bradlow J, Agass M, Martin-Bates C, Tulloch A. Outcomes of referrals to gynaecology outpatient clinics for menstrual problems: an audit of general practice records. Br J Obstet Gynaecol. 1991 Aug; 98 (8): 789-796. Farquar CM, Lethaby A, Sowter M, Verry J, Baranyai J. An evaluation of risk factors for endometrial hyperplasia in premenopausal women with abnormal menstrual bleeding. Am J Obstet Gynecol. 1999 Sep; 181 (3): 525-529. Fender GR, Prentice A, Gorst T, Nixon RM, Duffy SW, Day NE, Smith SK. Randomised controlled trial of educational package on management of menorrhagia in primary care: the Anglia menorrhagia education study. BMJ. 1999 May 8; 318 (7193): 1246-1250. Hammond RH, Oppenheimer LW, Saunders PG. Diagnostic role of dilatation and curettage in the management of abnormal premenopausal bleeding. Br J Obstet Gynaecol. 1989 Apr; 96 (4): 496-497. Jeffery JD, Taylor R, Robertson DI, Stuart GC. Endometrial carcinoma occurring in patients under the age of 45 years. Am J Obstet Gynecol. 1987 Feb; 156 (2): 366-370. Vessey MP, Clarke JA, MacKenzie IZ. Dilatation and curettage in young women. Health Bull (Edinb). 1979 Mar; 37 (2): 59-62. University of Leeds, Nuffield Institute for Health; University of York, NHS Centre for Reviews and Dissemination. The management of menorrhagia: what are effective ways of treating excessive regular menstrual loss in primary and secondary care Effective Health Care 1995; 1 (9): 1-14. Quinn MA, Kneale BJ, Fortune DW. Endometrial carcinoma in premenopausal women: a clinicopathological study. Gynecol Oncol. 1985 Mar; 20 (3): 298-306.DOI: 10.1016/0090-8258(85)90211-2 Ward J, Sanson-Fisher R. Does a 3-day workshop for family medicine trainees improve preventive care? A randomized control trial. Prev Med 1996 Nov-Dec; 25 (6): 741-747.DOI: 10.1006/pmed.1996.0114 Domenighetti P, Luraschi P, Casabianca A, Gutzwiller F, Spinelli A, Pedrinis E, Repetto F. Effect of information campaign by the mass media on hysterectomy rates. Lancet. 1988 Dec 24-31; 2(8626-8627): 1470-1473.DOI: 10.1016/S0140-6736(88)90943-9 Nagele F, O'Connor H, Davies A, Badawy A, Mohamed H, Magos A. 2500 outpatient diagnostic hysteroscopies. Obstet Gynecol 1996 Jul; 88 (1): 87-92.DOI: 10.1016/0029-7844(96)00108-1 Glanville J, Haines M, Auston I. Finding information on clinical effectiveness. BMJ. 1998 Jul 18; 317 (7152): 200-203. Lomas J, Anderson GM, Dominick-Pierre K, Vayda E, Enkin MW, Hannah WJ. Do practice guidelines guide practice? The effect of a consensus statement on the practice of physicians. N Eng J Med. 1989 Nov 9; 321 (19): 1306-1311. Emanuel MH, Wamsteker K, Lammes FB. Is dilatation and curettage obsolete for diagnosing intrauterine disorders in premenopausal patients with persistent abnormal uterine bleeding Acta Obstet Gynecol Scand. 1997 Jan; 76 (1): 65-68. Bero LA, Grilli R, Grimshaw JM, Harvey E, Oxman AD, Thomson MA. Closing the gap between research and practice: an overview of systematic reviews of interventions to promote the implementation of research findings. The Cochrane Effective Practice and Organization of Care Review Group. BMJ. 1998 Aug 15; 317 (7156): 465-468. Davis DA, Thomson MA, Oxman AD, Haynes RB. Evidence for the effectiveness of CME. A review of 50 randomized trials. JAMA. 1992 Sep 2; 268 (9): 1111-1117. Lomas J, Enkin M, Anderson GM, Hannah WJ, Vayda E, Singer J. Opinion leaders vs audit and feedback to implement practice guidelines. Delivery after previous cesarean section. JAMA. 1991 May 1; 265 (17): 2202-2207. National Health Committee. Guidelines for the management of heavy menstrual bleeding. Wellington : National Health Committee; 1998. Weisman CS, Morlock LL, Teitelbaum MA, Klassen AC, Celentano DD. Practice changes in response to the malpractice litigation climate: Results of a Maryland physician survey. Med Care. 1989 Jan; 27 (1): 16-24. Coleman JS, Katz E, Menzel H. Medical innovation: A diffusion study. Indianapolis : Bobbs-Merrill; 1966. Haines A, Jones R. Implementing findings of research. BMJ. 1994 Jun 4; 308 (6942): 1488-1492. Wyatt JC, Paterson-Brown S, Johanson R, Altman DG, Bradburn MJ, Fisk NM. Randomised trial of educational visits to enhance use of systematic reviews in 25 obstetric units. BMJ. 1998 Oct 17; 317 (7165): 1041-1046. 1996 Nov-Dec; 25 1995 Sep 6; 274 2000 Apr; 107 1998 Aug 15; 317 1998 1993 Oct 23; 307 1995 1994 1996 Jul; 88 1989 Jan; 27 1995; 1 1999 May 8; 318 1996; 10 1997 Jan; 76 1991 May 1; 265 1999 1994; 8 1999 Sep; 181 1979 Mar; 37 1987 Feb; 156 1997 Sep; 12 1992 Sep 2; 268 1994 Jun 4; 308 1985 Mar; 20 1998 Jul 18; 317 1988 Dec 24-31; 2 1989 Nov 9; 321 1998 Oct 17; 317 1989 Apr; 96 1991 Aug; 98 1966 Davis DA (e_1_2_1_25_2) 1992; 268 Westgate J. (e_1_2_1_27_2) 1998 e_1_2_1_23_2 e_1_2_1_20_2 e_1_2_1_21_2 e_1_2_1_26_2 e_1_2_1_24_2 e_1_2_1_28_2 Oxman DA (e_1_2_1_31_2) 1995 e_1_2_1_29_2 (e_1_2_1_5_2) 1995; 1 National Health Committee. (e_1_2_1_7_2) 1998 e_1_2_1_6_2 e_1_2_1_30_2 e_1_2_1_4_2 e_1_2_1_2_2 e_1_2_1_11_2 (e_1_2_1_22_2) 1994 e_1_2_1_34_2 e_1_2_1_3_2 Vessey MP (e_1_2_1_9_2) 1979; 37 e_1_2_1_12_2 Coulter A. (e_1_2_1_15_2) 1996 e_1_2_1_32_2 e_1_2_1_10_2 e_1_2_1_16_2 Coleman JS (e_1_2_1_33_2) 1966 e_1_2_1_13_2 e_1_2_1_36_2 e_1_2_1_14_2 e_1_2_1_35_2 e_1_2_1_19_2 e_1_2_1_8_2 e_1_2_1_17_2 e_1_2_1_18_2 |
| References_xml | – reference: University of Leeds, Nuffield Institute for Health; University of York, NHS Centre for Reviews and Dissemination. The management of menorrhagia: what are effective ways of treating excessive regular menstrual loss in primary and secondary care Effective Health Care 1995; 1 (9): 1-14. – reference: Glanville J, Haines M, Auston I. Finding information on clinical effectiveness. BMJ. 1998 Jul 18; 317 (7152): 200-203. – reference: Ward J, Sanson-Fisher R. Does a 3-day workshop for family medicine trainees improve preventive care? A randomized control trial. Prev Med 1996 Nov-Dec; 25 (6): 741-747.DOI: 10.1006/pmed.1996.0114 – reference: Quinn MA, Kneale BJ, Fortune DW. Endometrial carcinoma in premenopausal women: a clinicopathological study. Gynecol Oncol. 1985 Mar; 20 (3): 298-306.DOI: 10.1016/0090-8258(85)90211-2 – reference: Davis DA, Thomson MA, Oxman AD, Haynes RB. Changing physician performance. A systematic review of the effect of continuing medical education strategies. JAMA. 1995 Sep 6; 274 (9): 700-705. – reference: Haines A, Jones R. Implementing findings of research. BMJ. 1994 Jun 4; 308 (6942): 1488-1492. – reference: Bero LA, Grilli R, Grimshaw JM, Harvey E, Oxman AD, Thomson MA. Closing the gap between research and practice: an overview of systematic reviews of interventions to promote the implementation of research findings. The Cochrane Effective Practice and Organization of Care Review Group. BMJ. 1998 Aug 15; 317 (7156): 465-468. – reference: National Health Committee. Guidelines for the management of heavy menstrual bleeding. Wellington : National Health Committee; 1998. – reference: Farquar CM, Lethaby A, Sowter M, Verry J, Baranyai J. An evaluation of risk factors for endometrial hyperplasia in premenopausal women with abnormal menstrual bleeding. Am J Obstet Gynecol. 1999 Sep; 181 (3): 525-529. – reference: Penney G, Vale L, Souter V, Templeton A. Endometrial assessment procedures: an audit of current practice in Scotland. Hum Reprod. 1997 Sep; 12 (9): 2041-2045.DOI: 10.1093/humrep/12.9.2041 – reference: Davis DA, Thomson MA, Oxman AD, Haynes RB. Evidence for the effectiveness of CME. A review of 50 randomized trials. JAMA. 1992 Sep 2; 268 (9): 1111-1117. – reference: Chadha Y, Mollison J, Howie F, Grimshaw J, Hall M, Russell I. Guidelines in gynaecology; evaluation in menorrhagia and in urinary incontinence. BJOG. 2000 Apr; 107 (4): 535-543. – reference: Emanuel MH, Wamsteker K, Lammes FB. Is dilatation and curettage obsolete for diagnosing intrauterine disorders in premenopausal patients with persistent abnormal uterine bleeding Acta Obstet Gynecol Scand. 1997 Jan; 76 (1): 65-68. – reference: Lomas J, Anderson GM, Dominick-Pierre K, Vayda E, Enkin MW, Hannah WJ. Do practice guidelines guide practice? The effect of a consensus statement on the practice of physicians. N Eng J Med. 1989 Nov 9; 321 (19): 1306-1311. – reference: Jeffery JD, Taylor R, Robertson DI, Stuart GC. Endometrial carcinoma occurring in patients under the age of 45 years. Am J Obstet Gynecol. 1987 Feb; 156 (2): 366-370. – reference: Coulter A, Bradlow J, Agass M, Martin-Bates C, Tulloch A. Outcomes of referrals to gynaecology outpatient clinics for menstrual problems: an audit of general practice records. Br J Obstet Gynaecol. 1991 Aug; 98 (8): 789-796. – reference: Domenighetti P, Luraschi P, Casabianca A, Gutzwiller F, Spinelli A, Pedrinis E, Repetto F. Effect of information campaign by the mass media on hysterectomy rates. Lancet. 1988 Dec 24-31; 2(8626-8627): 1470-1473.DOI: 10.1016/S0140-6736(88)90943-9 – reference: Vessey MP, Clarke JA, MacKenzie IZ. Dilatation and curettage in young women. Health Bull (Edinb). 1979 Mar; 37 (2): 59-62. – reference: Fender GR, Prentice A, Gorst T, Nixon RM, Duffy SW, Day NE, Smith SK. Randomised controlled trial of educational package on management of menorrhagia in primary care: the Anglia menorrhagia education study. BMJ. 1999 May 8; 318 (7193): 1246-1250. – reference: Hammond RH, Oppenheimer LW, Saunders PG. Diagnostic role of dilatation and curettage in the management of abnormal premenopausal bleeding. Br J Obstet Gynaecol. 1989 Apr; 96 (4): 496-497. – reference: Nagele F, O'Connor H, Davies A, Badawy A, Mohamed H, Magos A. 2500 outpatient diagnostic hysteroscopies. Obstet Gynecol 1996 Jul; 88 (1): 87-92.DOI: 10.1016/0029-7844(96)00108-1 – reference: Lomas J, Enkin M, Anderson GM, Hannah WJ, Vayda E, Singer J. Opinion leaders vs audit and feedback to implement practice guidelines. Delivery after previous cesarean section. JAMA. 1991 May 1; 265 (17): 2202-2207. – reference: Wyatt JC, Paterson-Brown S, Johanson R, Altman DG, Bradburn MJ, Fisk NM. Randomised trial of educational visits to enhance use of systematic reviews in 25 obstetric units. BMJ. 1998 Oct 17; 317 (7165): 1041-1046. – reference: Coleman JS, Katz E, Menzel H. Medical innovation: A diffusion study. Indianapolis : Bobbs-Merrill; 1966. – reference: Weisman CS, Morlock LL, Teitelbaum MA, Klassen AC, Celentano DD. Practice changes in response to the malpractice litigation climate: Results of a Maryland physician survey. Med Care. 1989 Jan; 27 (1): 16-24. – reference: Bath PM, Prasad A, Brown MM, MacGregor GA. Survey of use of anticoagulation in patients with atrial fibrillation. BMJ. 1993 Oct 23; 307 (6911): 1045. – volume: 37 start-page: 59 issue: 2 year: 1979 Mar end-page: 62 article-title: Dilatation and curettage in young women publication-title: Health Bull (Edinb). – volume: 88 start-page: 87 issue: 1 year: 1996 Jul end-page: 92 article-title: 2500 outpatient diagnostic hysteroscopies publication-title: Obstet Gynecol – volume: 181 start-page: 525 issue: 3 year: 1999 Sep end-page: 529 article-title: An evaluation of risk factors for endometrial hyperplasia in premenopausal women with abnormal menstrual bleeding publication-title: Am J Obstet Gynecol. – volume: 96 start-page: 496 issue: 4 year: 1989 Apr end-page: 497 article-title: Diagnostic role of dilatation and curettage in the management of abnormal premenopausal bleeding publication-title: Br J Obstet Gynaecol. – year: 1966 – volume: 2 start-page: 1470 issue: 8626‐8627 year: 1988 Dec 24-31 end-page: 1473 article-title: Effect of information campaign by the mass media on hysterectomy rates publication-title: Lancet – volume: 317 start-page: 1041 issue: 7165 year: 1998 Oct 17 end-page: 1046 article-title: Randomised trial of educational visits to enhance use of systematic reviews in 25 obstetric units publication-title: BMJ – volume: 76 start-page: 65 issue: 1 year: 1997 Jan end-page: 68 article-title: Is dilatation and curettage obsolete for diagnosing intrauterine disorders in premenopausal patients with persistent abnormal uterine bleeding publication-title: Acta Obstet Gynecol Scand. – volume: 317 start-page: 465 issue: 7156 year: 1998 Aug 15 end-page: 468 article-title: Closing the gap between research and practice: an overview of systematic reviews of interventions to promote the implementation of research findings. The Cochrane Effective Practice and Organization of Care Review Group publication-title: BMJ – volume: 107 start-page: 535 issue: 4 year: 2000 Apr end-page: 543 article-title: Guidelines in gynaecology; evaluation in menorrhagia and in urinary incontinence publication-title: BJOG – volume: 321 start-page: 1306 issue: 19 year: 1989 Nov 9 end-page: 1311 article-title: Do practice guidelines guide practice? The effect of a consensus statement on the practice of physicians publication-title: N Eng J Med. – volume: 1 start-page: 1 issue: 9 year: 1995 end-page: 14 article-title: The management of menorrhagia: what are effective ways of treating excessive regular menstrual loss in primary and secondary care publication-title: Effective Health Care – volume: 268 start-page: 1111 issue: 9 year: 1992 Sep 2 end-page: 1117 article-title: Evidence for the effectiveness of CME. A review of 50 randomized trials publication-title: JAMA – year: 1994 – year: 1998 – volume: 25 start-page: 741 issue: 6 year: 1996 Nov-Dec end-page: 747 article-title: Does a 3‐day workshop for family medicine trainees improve preventive care? A randomized control trial publication-title: Prev Med – volume: 8 start-page: 1 issue: Issue 1 year: 1994 end-page: 12 – volume: 98 start-page: 789 issue: 8 year: 1991 Aug end-page: 796 article-title: Outcomes of referrals to gynaecology outpatient clinics for menstrual problems: an audit of general practice records publication-title: Br J Obstet Gynaecol. – volume: 12 start-page: 2041 issue: 9 year: 1997 Sep end-page: 2045 article-title: Endometrial assessment procedures: an audit of current practice in Scotland publication-title: Hum Reprod. – volume: 318 start-page: 1246 issue: 7193 year: 1999 May 8 end-page: 1250 article-title: Randomised controlled trial of educational package on management of menorrhagia in primary care: the Anglia menorrhagia education study publication-title: BMJ – volume: 265 start-page: 2202 issue: 17 year: 1991 May 1 end-page: 2207 article-title: Opinion leaders vs audit and feedback to implement practice guidelines. Delivery after previous cesarean section publication-title: JAMA – issue: Issue 1 year: 1999 – volume: 156 start-page: 366 issue: 2 year: 1987 Feb end-page: 370 article-title: Endometrial carcinoma occurring in patients under the age of 45 years publication-title: Am J Obstet Gynecol. – year: 1995 – volume: 20 start-page: 298 issue: 3 year: 1985 Mar end-page: 306 article-title: Endometrial carcinoma in premenopausal women: a clinicopathological study publication-title: Gynecol Oncol. – volume: 274 start-page: 700 issue: 9 year: 1995 Sep 6 end-page: 705 article-title: Changing physician performance. A systematic review of the effect of continuing medical education strategies publication-title: JAMA – volume: 317 start-page: 200 issue: 7152 year: 1998 Jul 18 end-page: 203 article-title: Finding information on clinical effectiveness publication-title: BMJ – volume: 308 start-page: 1488 issue: 6942 year: 1994 Jun 4 end-page: 1492 article-title: Implementing findings of research publication-title: BMJ – volume: 10 start-page: 715 year: 1996 end-page: 729 – volume: 307 start-page: 1045 issue: 6911 year: 1993 Oct 23 article-title: Survey of use of anticoagulation in patients with atrial fibrillation publication-title: BMJ – volume: 27 start-page: 16 issue: 1 year: 1989 Jan end-page: 24 article-title: Practice changes in response to the malpractice litigation climate: Results of a Maryland physician survey publication-title: Med Care. – year: 1999 – ident: e_1_2_1_20_2 doi: 10.1136/bmj.317.7152.200 – ident: e_1_2_1_11_2 doi: 10.1016/0002-9378(87)90285-7 – ident: e_1_2_1_14_2 – ident: e_1_2_1_28_2 doi: 10.1111/j.1471-0528.1991.tb13484.x – ident: e_1_2_1_12_2 doi: 10.1016/0090-8258(85)90211-2 – ident: e_1_2_1_29_2 doi: 10.1056/NEJM198911093211906 – volume-title: Guidelines for the management of heavy menstrual bleeding year: 1998 ident: e_1_2_1_27_2 – start-page: 715 volume-title: Clin Obstet Gynaecol year: 1996 ident: e_1_2_1_15_2 – volume-title: Evidence based practice in primary care. year: 1995 ident: e_1_2_1_31_2 – ident: e_1_2_1_13_2 – volume-title: Medical innovation: A diffusion study year: 1966 ident: e_1_2_1_33_2 – ident: e_1_2_1_6_2 – ident: e_1_2_1_19_2 doi: 10.1001/jama.1995.03530090032018 – ident: e_1_2_1_3_2 doi: 10.1093/humrep/12.9.2041 – ident: e_1_2_1_24_2 doi: 10.1001/jama.1991.03460170056033 – volume-title: Guidelines for the management of heavy menstrual bleeding year: 1998 ident: e_1_2_1_7_2 – ident: e_1_2_1_32_2 doi: 10.1136/bmj.317.7165.1041 – ident: e_1_2_1_35_2 doi: 10.1111/j.1471-0528.2000.tb13275.x – ident: e_1_2_1_26_2 doi: 10.1136/bmj.318.7193.1246 – start-page: 1 volume-title: Effective Health Care. year: 1994 ident: e_1_2_1_22_2 – volume: 268 start-page: 1111 issue: 9 year: 1992 ident: e_1_2_1_25_2 article-title: Evidence for the effectiveness of CME. A review of 50 randomized trials publication-title: JAMA doi: 10.1001/jama.1992.03490090053014 – ident: e_1_2_1_16_2 doi: 10.1006/pmed.1996.0114 – ident: e_1_2_1_21_2 – ident: e_1_2_1_17_2 doi: 10.1136/bmj.307.6911.1045 – ident: e_1_2_1_36_2 doi: 10.1016/S0140-6736(88)90943-9 – ident: e_1_2_1_30_2 doi: 10.1097/00005650-198901000-00002 – ident: e_1_2_1_4_2 doi: 10.1016/0029-7844(96)00108-1 – ident: e_1_2_1_23_2 – volume: 1 start-page: 1 issue: 9 year: 1995 ident: e_1_2_1_5_2 article-title: The management of menorrhagia: what are effective ways of treating excessive regular menstrual loss in primary and secondary care publication-title: Effective Health Care – ident: e_1_2_1_18_2 doi: 10.1136/bmj.317.7156.465 – ident: e_1_2_1_34_2 doi: 10.1136/bmj.308.6942.1488 – volume: 37 start-page: 59 issue: 2 year: 1979 ident: e_1_2_1_9_2 article-title: Dilatation and curettage in young women publication-title: Health Bull (Edinb). – ident: e_1_2_1_8_2 doi: 10.1111/j.1471-0528.1989.tb02433.x – ident: e_1_2_1_2_2 doi: 10.3109/00016349709047787 – ident: e_1_2_1_10_2 doi: 10.1016/S0002-9378(99)70487-4 |
| SSID | ssj0019514 |
| Score | 1.6484683 |
| Snippet | ABSTRACT
Objectives
To assess the effectiveness of an integrated educational strategy to change clinician behaviour and reduce the number of hysteroscopies... To assess the effectiveness of an integrated educational strategy to change clinician behaviour and reduce the number of hysteroscopies and/or dilatation and... |
| SourceID | proquest pubmed crossref wiley istex |
| SourceType | Aggregation Database Index Database Enrichment Source Publisher |
| StartPage | 397 |
| SubjectTerms | Adult Curettage - statistics & numerical data Education, Medical, Continuing Evidence-Based Medicine Female Gynecology - education Health Services Research Hospitals, Teaching Humans Hysteroscopy - statistics & numerical data Information Dissemination Male Middle Aged Practice Patterns, Physicians Uterine Hemorrhage - prevention & control Victoria |
| Title | Randomised trial of an integrated educational strategy to reduce investigation rates in young women with dysfunctional uterine bleeding |
| URI | https://api.istex.fr/ark:/67375/WNG-BHXZKGQF-7/fulltext.pdf https://onlinelibrary.wiley.com/doi/abs/10.1111%2Fj.0004-8666.2002.00397.x https://www.ncbi.nlm.nih.gov/pubmed/12403289 https://www.proquest.com/docview/72619246 |
| Volume | 42 |
| hasFullText | 1 |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| journalDatabaseRights | – providerCode: PRVWIB databaseName: Wiley Online Library - Core collection (SURFmarket) issn: 0004-8666 databaseCode: DR2 dateStart: 19970101 customDbUrl: isFulltext: true eissn: 1479-828X dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0019514 providerName: Wiley-Blackwell |
| link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwrV1La9wwEBYlhdJL3w83fehQevOysiXLPqalmyUlKQ0NXXoReowvG-yy3oVs_0D_djSS7bAhhxB6M5ZH1mMkfSONviHko5PGVbwu0tJm3kARhUl1XdapxAhXbmpBFHjB-fikmJ_xo4VY9P5PeBcm8kOMG244MsJ8jQNcm25nkCMeSUuPv4OnwQSvmcoJ4kmWF8G6Oh2ZpFjV03wPIjtOPTdntLNS3cdGv7gJhu6i2rAszR6T5VCh6I2ynGzWZmL_XuN6_D81fkIe9eiVHkR1e0ruQfOMPDjuz-efk3-nunGtVx1wNMQDoW1NdUNHUgpHYfAo8YldpMbd0nVLV5gA_suR96NtKCZ3_h3d4qREA10Exa1j6rYdLsl9RhiXwheAmvO4GL8gZ7OvP7_M0z7UQ2rznMuUcQeV0LbShmU1yyHLjFce7Y135yFM6a1YCWVZaO3hjuEZCCFtVTsOmS1rEPlLste0DbwmlGcOOKuAa7DetrKagbFTLZmzUzuFPCFy6FZlex50DMdxrq7sIWxnhe2MUTozFdpZXSSEjZJ_IhfILWQ-Bc0ZBfRqib50UqhfJ4fq83zx-9vhj5mSCfkwqJby3YTHNrqBdtMpGa3kIiGvosZd_RzJFL3FnBAR9ObWpVIHR9_9w5s7yu2ThzEoDvo0viV769UG3nlstjbvw6i7BEimLAw |
| linkProvider | Wiley-Blackwell |
| linkToHtml | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwrV1Lb9QwELZQKwEXXi0QXvUB9ZbVJrHj5FgQ26XtLqJqxaoXy7Enl64StA-pyx_gbzMTJ6kW9VAhblGccfwY29_Y428Y--hU4XJRpmFmYzRQZFqEpszKUFGEKze0IFO64DyZpuNLcTKTszYcEN2F8fwQ_YYbjYxmvqYBThvSW6OcAEmYIQBvXA0GdM9UDRBQ7ooUzRZCSOc9l1SUt0TfncyWW8_dOW2tVbvU7Dd3AdFtXNssTKOnbN5VyfujXA_Wq2Jgf_3F9vif6vyMPWkBLD_yGvecPYDqBXs4aY_o99jvc1O5GrUHHG9CgvC65KbiPS-F49A5lWDi0rPjbviq5gtKAPyyp_6oK07JS3zHNzQv8YYxgtPuMXebJa3KbUYUmgILwIu5X4_32eXoy8XncdhGewhtkggVRsJBLo3NTRHFZZRAHBeoPwbtd4coJkNDVkGWpcYg4ilEDFIqm5dOQGyzEmTyku1UdQWvGRexAxHlIAxYNK-siaCwQ6MiZ4d2CEnAVNev2rZU6BSRY65vTSJqZ03tTIE6Y920s74JWNRL_vR0IPeQOWxUpxcwi2typ1NS_5ge60_j2dXp8feRVgE76HRLYzfRyY2poF4vtfKGchqwV17lbn9OfIpoNAdMNopz71Lpo5Nv-PDmH-UO2KPxxeRMn32dnr5lj32MHHJxfMd2Vos1vEeotio-NEPwDxY_MC0 |
| linkToPdf | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwrV1Lb9QwELZQK1VceD_SFuoD4pbVJrHj5Fhot0tLF6ioWHGx_JhcukqqfUhd_gB_G4-dpFrUQ4W4RXHG8WNsf2OPvyHknRXalqzK48KkzkDhuY5VVVSxwAhXdmiA53jB-XySjy_Z6ZRP23BAeBcm8EP0G244Mvx8jQMcrm21McoRkMSFA-De1WCA90zFwAHKbcbLAv37ji56LqmkbIm-O5kNt567c9pYq7ax2W_uAqKbuNYvTKPHZNZVKfijXA1WSz0wv_5ie_xPdX5CHrUAlh4GjXtKHkD9jOyct0f0z8nvC1XbxmkPWOpDgtCmoqqmPS-FpdA5lbjERWDHXdNlQ-eYAO7LnvqjqSkmL9w7usZ5iXrGCIq7x9SuF7gqtxlhaApXAKpnYT1-QS5Hx98_juM22kNssoyJOGEWSq5MqXSSVkkGaaqd_ihnv1uHYgpnyAooilwph3g0S4FzYcrKMkhNUQHPXpKtuqnhNaEstcCSEpgC48wroxLQZqhEYs3QDCGLiOj6VZqWCh0jcszkrUmE7SyxnTFQZyp9O8ubiCS95HWgA7mHzHuvOr2Aml-hO53g8sfkRH4YT3-enXwbSRGRg063pOsmPLlRNTSrhRTBUM4j8iqo3O3PkU_RGc0R4V5x7l0qeXj6xT3s_qPcAdn5ejSSnz9NzvbIwxAiBz0c98nWcr6CNw6pLfVbPwL_AHuHL7E |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Randomised+trial+of+an+integrated+educational+strategy+to+reduce+investigation+rates+in+young+women+with+dysfunctional+uterine+bleeding&rft.jtitle=Australian+%26+New+Zealand+journal+of+obstetrics+%26+gynaecology&rft.au=Searle%2C+Judith&rft.au=Grover%2C+Sonia&rft.au=Santin%2C+Anita&rft.au=Weideman%2C+Prue&rft.date=2002-10-01&rft.issn=0004-8666&rft.eissn=1479-828X&rft.volume=42&rft.issue=4&rft.spage=397&rft.epage=402&rft_id=info:doi/10.1111%2Fj.0004-8666.2002.00397.x&rft.externalDBID=n%2Fa&rft.externalDocID=10_1111_j_0004_8666_2002_00397_x |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0004-8666&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0004-8666&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0004-8666&client=summon |