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01.06.2009 | Original Article

Clinical-decision taking in primary pelvic organ prolapse; the effects of diagnostic tests on treatment selection in comparison with a consensus meeting

verfasst von: Annette G. Groenendijk, Erwin Birnie, Sjoerd de Blok, Albert H. Adriaanse, Willem M. Ankum, Jan-Paul W. Roovers, Gouke J. Bonsel

Erschienen in: International Urogynecology Journal | Ausgabe 6/2009

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Abstract

Introduction and hypothesis

The objective of the study was to establish the effects of additional diagnostic tests compared to a consensus outcome on treatment selection in primary pelvic organ prolapse.

Methods

Three expert gynecologists individually defined a management plan in 53 patients after magnetic resonance imaging, defecography, urodynamic, and anorectal function test information was provided. These management plans were compared with basic treatment advices in the absence of any test and with consensus advices (opinion-based references). The experts assigned a subjective score (assigned diagnostic value [ADV], 0–100%) to rate the test's relative importance.

Results

On average, additional diagnostic testing resulted in a revised initial management plan in 38% of the cases; 24% of the individual management plans did not meet the consensus reference. Overall defecography was regarded most valuable (ADV range 19–65%) vs. magnetic resonance imaging rated least (ADV range 0–37%).

Conclusions

Although additional diagnostic tests frequently led to adaptations of basic treatment proposals, consensus was not reached in a fourth of the cases.

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Titel: Clinical-decision taking in primary pelvic organ prolapse; the effects of diagnostic tests on treatment selection in comparison with a consensus meeting
verfasst von: Annette G. Groenendijk
Erwin Birnie
Sjoerd de Blok
Albert H. Adriaanse
Willem M. Ankum
Jan-Paul W. Roovers
Gouke J. Bonsel
Publikationsdatum: 01.06.2009
Verlag: Springer-Verlag
Erschienen in: International Urogynecology Journal / Ausgabe 6/2009
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-009-0846-5

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Clinical-decision taking in primary pelvic organ prolapse; the effects of diagnostic tests on treatment selection in comparison with a consensus meeting