Transactions of the Twenty-Eighth Scientific Meeting of the Society of Gynecological SurgeonsGuidelines for the selection of the route of hysterectomy: Application in a resident clinic population☆
Section snippets
Methods
Data were collected from the charts of 407 women from the resident clinic population who had consecutive hysterectomies at Wright State University between 1994 and 1999. The resident staff, in consultation with the gynecologic faculty, was responsible for the selection of the route of hysterectomy according to the SPRS guidelines. Thirty fourth-year resident physicians performed all hysterectomies during this period, with the technical assistance of 7 faculty gynecologic surgeons with different
Results
In the 407 consecutive women in whom the route of hysterectomy was selected by resident physicians according to the SPRS guidelines, the ratio of abdominal-to-vaginal hysterectomy decreased from 3:1 in the 1989 to 1993 study period to 1:11 in the 1994 to 1999 study period. This ratio was compared with other residency programs in the United States and Canada, which reported a 3:1 ratio of abdominal-to-vaginal hysterectomy.
The first step in the decision-making pathway related to the accessibility
Comment
Considerable variation has been observed in the health care services for hysterectomy from community to community, physician to physician, and residency programs. Practice parameters have been developed for many conditions as a tool to help physicians practice more effectively; the American Medical Association launched a drive to support practice guideline development. Parameters that were developed by physician organizations (such as the SPRS) survey the scientific research and other sources
Acknowledgements
We thank Manling Chen from the Statistical Consulting Center, Wright State University, for providing the statistical analyses.
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