Women's health reviews

Women's health is one of the main areas of research interest at BCTU. Please find some of our current systematic reviews and meta-analyses in this area below:

Heavy Menstrual Bleeding IPD Meta-analysis

THE INTERNATIONAL HEAVY MENSTRUAL BLEEDING IPD META-ANALYSIS COLLABORATIVE GROUP

In this project we compared, using individual patient data (IPD) meta-analysis of existing randomised controlled trials, the short to medium term effects of the Mirena IUS system, various endometrial ablative techniques and hysterectomy. IPD meta-analysis enabled us to explore if there were any specific subgroups of women who were most likely to benefit from either hysterectomy or specific types of ablation. We also examined which of the commonly used second generation ablation techniques was the most effective and cost-effective.

Authors of all primary randomised controlled trials in menorrhagia (heavy menstrual bleeding - HMB) were contacted for their individual patient data. The overview protocol is available below as are details of the collaborative group.

To contact the HMB Collaborative Group Secretariat, please email overviews@bham.ac.uk

The project was funded by the NIHR Health Technology Assessment Programme and was a collaboration between the Department of Obstetrics and Gynaecology and Birmingham Clinical Trials Unit at the University of Birmingham and the University of Aberdeen.

Study Protocol
Please view the study protocol to find out more about this project

Collaborators
The International HMB IPD Meta-analysis Collaborative Group is overseen by a Management Group:

Aberdeen, UK, Siladitya Bhattacharya s.bhattacharya@abdn.ac.uk  
Aberdeen, UK, Kevin Cooper kevin.cooper@nhs.net  
Birmingham, UK, Khalid S. Khan k.s.khan@bham.ac.uk  
Birmingham, UK, Jane Daniels j.p.daniels@bham.ac.uk  
Birmingham, UK, Lee Middleton l.j.middleton@bham.ac.uk  
Birmingham, UK, Rita Champaneria r.champaneria@bham.ac.uk  
Birmingham, UK, Richard Gray r.gray@bham.ac.uk  

News
INTERNATIONAL HMB IPD META-ANALYSIS

Following a successful preliminary meeting at the ESGE conference in Amsterdam 2008, the HMB IPD MA team presented full results the following year at the ESGE conference in Florence.

Again, many thanks to all those of you who submitted patient data for inclusion in our project.

Publications
This piece of work has generated a number of publications including:

A meta-analysis providing results of the main analyses

The HTA monograph which gives a detailed breakdown of all the different components of this project

A cost-effectiveness analysis based on results of the meta-analysis mentioned above

A network meta-analysis, concentrating on second generation ablative techniques 

Pelvic Congestion Syndrome reviews

This project was funded by the NIHR Health Technology Assessment programme in response to their open call for an evidence synthesis project to answer the question of whether there is a relationship between refluxing pelvic veins and pelvic pain.

To answer this question we will be undertaking the following projects:

- Systematic review of the relationship between chronic pelvic pain and radiological evidence of refluxing pelvic veins.

- Systematic review of the effectiveness of embolisation and ligation of pelvic/ovarian veins. We hope to collect IPD (individual patient data) from the included trials in order to identify factors which will predict a successful outcome. If we receive enough IPD we will carry out an IPD-meta analysis.

- Survey UK, European and international use of pelvic vein embolisation/schlerotherapy amongst gynaecologists, interventional radiologists and vascular specialists.

- Elicit clinicians' prior beliefs on the effectiveness of embolisation/schlerotherapy for pelvic congestion syndrome.

This will culminate in establishing the need for, and potential gain from, a randomised controlled trial of pelvic vein embolisation or schlerotherapy for pelvic congestion syndrome 

WHO Maternal Mortality review

Collaborators
This project was undertaken by a team at the University of Birmingham, but was commissioned by the World Health Organisation (WHO), who together with Simon Cousens oversaw the running of the project.

Team from the WHO:
Metin Gulmezoglu
Lale Say
Doris Chou

Team from Birmingham:
Khalid Khan
Jane Daniels
Andrew Howman
Rita Champaneria
Manjo Doug

Team from London School of Hygiene & Tropical Medicine:
Simon Cousens 

News
Full results of this project will be published shortly in the Lancet.