We will discuss “Premenopausal abnormal uterine bleeding and risk of endometrial cancer” by Pennant and co-workers from 30 November 2016 for 7 days.
Start date: 30 November 2016 (the discussion will continue for 7 days between 30 November – 7 December 2016)
First hosted discussion session(s) on Twitter starts at GMT+1 (British Summer Time) 8pm on 30 November 2016 (using hashtag #BlueJC)
The Blue Journal Club is an international journal club on women’s health research based on Twitter (as @BlueJCHost). We start our conversation on the last Wednesday of every month and use the hashtag #BlueJC for our tweets. Simply add this hashtag (“#BlueJC”) to each tweet and we will capture it. Each #BlueJC opens for 7 days with an advertised start time. All BJOG #BlueJC papers also have complementary slide sets suitable for face-to-face journal clubs with your local colleagues.
The discussion points are attached below (quoted from the published Journal Club guide)
A 32-year-old nulliparous woman presented to your clinic with bleeding in between her periods for the past 6 months.
Her periods had been regular prior to her new symptom. She had an up-to-date and normal smear, and recent tests for genital tract infections were negative. She had no other medical history.
How would you manage this woman?
Description of research
|Participants||Studies reporting rates of endometrial carcinoma and/or atypical hyperplasia of women with pre-menopausal abnormal uterine bleeding|
|Intervention||Endometrial biopsy and histological analysis|
|Comparison||Prevalence of endometrial malignancy|
|Outcomes||Risk of endometrial cancer or atypical hyperplasia|
|Study design||Studies reporting rates of endometrial carcinoma and/or atypical hyperplasia of women with pre-menopausal abnormal uterine bleeding|
|Authors’ conclusion||The combined risk of endometrial cancer is low (0.34%; 95% CI 0.28 to 0.42%, n=28,162; 96 cases)|
- Which additional factors would you consider when you manage the woman in the above scenario?
- How do you currently manage the women in the clinical scenario?
- What is the best way to determine the prevalence of a disease in different subgroups of the population?
- What are the strengths and weaknesses of this meta-analysis for this research question? (see suggested reading)
- In particular, do you have additional comments with regards to the search strategy and selection criteria?
- What is the prevalence (with confidence intervals) of endometrial cancer and atypical hyperplasia identified in this study?
- Are the results of the existing study consistent with published guidelines?
Scottish Intercollegiate Guidelines Network. Critical Appraisal: notes and checklists. Methodology checklist 1: Systematic reviews and meta-analyses. http://www.sign.ac.uk/methodology/checklists.html (Last access 20 July 2016)
For those who want to understand hashtags, this may be a useful guide. For an introduction to #BlueJC, please refer to BJOG 2013;120:657–60. Follow @BlueJCHost, this blog and our Facebook page to receive news about #BlueJC.