Skip to content Skip to navigation
University of Warwick
  • Study
  • |
  • Research
  • |
  • Business
  • |
  • Alumni
  • |
  • News
  • |
  • About

University of Warwick
Publications service & WRAP

Highlight your research

  • WRAP
    • Home
    • Search WRAP
    • Browse by Warwick Author
    • Browse WRAP by Year
    • Browse WRAP by Subject
    • Browse WRAP by Department
    • Browse WRAP by Funder
    • Browse Theses by Department
  • Publications Service
    • Home
    • Search Publications Service
    • Browse by Warwick Author
    • Browse Publications service by Year
    • Browse Publications service by Subject
    • Browse Publications service by Department
    • Browse Publications service by Funder
  • Help & Advice
University of Warwick

The Library

  • Login
  • Admin

Development and preliminary evaluation of a clinical guidance programme for the decision about prophylactic oophorectomy in women undergoing a hysterectomy

Tools
- Tools
+ Tools

Pell, I., Dowie, J., Clarke, Aileen, Kennedy, A. and Bhavnani, V. (2002) Development and preliminary evaluation of a clinical guidance programme for the decision about prophylactic oophorectomy in women undergoing a hysterectomy. BMJ Quality and Safety, Vol.11 (No.1). pp. 32-38. doi:10.1136/qhc.11.1.32 ISSN 2044-5423.

[img]
Preview
PDF
WRAP_Clarke_prophylactic_oophorectomy.pdf - Requires a PDF viewer.

Download (371Kb)
Official URL: http://dx.doi.org/10.1136/qhc.11.1.32

Request Changes to record.

Abstract

Objectives: To develop a decision analysis based and computerised clinical guidance programme
(CGP) that provides patient specific guidance on the decision whether or not to undergo a prophylactic
oophorectomy to reduce the risk of subsequent ovarian cancer and to undertake a preliminary pilot
and evaluation.
Subjects: Women who had already agreed to have a hysterectomy who otherwise had no ovarian
pathology.
Setting: Oophorectomy decision consultation at the outpatient or pre-admission clinic.
Methods: A CGP was developed with advice from gynaecologists and patient groups, incorporating
a set of Markov models within a decision analytical framework to evaluate the benefits of undergoing
a prophylactic oophorectomy or not on the basis of quality adjusted life expectancy, life expectancy,
and for varying durations of hormone replacement therapy. Sensitivity analysis and preliminary testing
of the CGP were undertaken to compare its overall performance with established guidelines and practice.
A small convenience sample of women invited to use the CGP were interviewed, the interviews
were taped and transcribed, and a thematic analysis was undertaken.
Results: The run time of the programme was 20 minutes, depending on the use of opt outs to default
values. The CGP functioned well in preliminary testing. Women were able to use the programme and
expressed overall satisfaction with it. Some had reservations about the computerised format and some
were surprised at the specificity of the guidance given.
Conclusions: A CGP can be developed for a complex healthcare decision. It can give evidence-based
health guidance which can be adjusted to account for individual risk factors and reflects a patient’s
own values and preferences concerning health outcomes. Future decision aids and support systems
need to be developed and evaluated in a way which takes account of the variation in patients’ preferences
for inclusion in the decision making process.

Item Type: Journal Article
Subjects: R Medicine > R Medicine (General)
R Medicine > RD Surgery
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) > Warwick Evidence
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Hysterectomy, Ovariectomy, Clinical medicine -- Decision making -- Computer programs, Expert systems (Computer science)
Journal or Publication Title: BMJ Quality and Safety
Publisher: BMJ Group
ISSN: 2044-5423
Official Date: 2002
Dates:
DateEvent
2002Published
Volume: Vol.11
Number: No.1
Page Range: pp. 32-38
DOI: 10.1136/qhc.11.1.32
Status: Peer Reviewed
Access rights to Published version: Open Access (Creative Commons)
Funder: NHS Executive. Research and Development Directorate

Request changes or add full text files to a record

Repository staff actions (login required)

View Item View Item

Downloads

Downloads per month over past year

View more statistics

twitter

Email us: wrap@warwick.ac.uk
Contact Details
About Us