Evidence map›Paper›PMID 33568437›Full record

Observational studyJournal of medical genetics2022

Surgical decision making in premenopausal

Faiza Gaba, Shivam Goyal, Dalya Marks, Dhivya Chandrasekaran, Olivia Evans, Sadiyah Robbani, Charlotte Tyson, Rosa Legood, Ertan Saridogan, W Glenn McCluggage and 6 more

Open access · hybridAbstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Journal of medical genetics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 1 pooled it
2.9field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.

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  13. Screening and prevention of ovarian cancer.The Medical journal of Australia · 2024
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 8 institutions in 5 countries.

Faiza GabaWolfson Institute of Preventive Medicine, Barts CRUK Centre, Queen Mary University of London-Charterhouse Square Campus, London, UK.
Shivam GoyalWolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK.
Dalya MarksDepartment of Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK.
Dhivya ChandrasekaranWolfson Institute of Preventive Medicine, Barts CRUK Centre, Queen Mary University of London-Charterhouse Square Campus, London, UK.
Olivia EvansWolfson Institute of Preventive Medicine, Barts CRUK Centre, Queen Mary University of London-Charterhouse Square Campus, London, UK.
Sadiyah RobbaniCentre for Experimental Cancer Medicine, Barts CRUK Cancer Centre, Queen Mary University of London, London, UK.
Charlotte TysonCentre for Experimental Cancer Medicine, Barts CRUK Cancer Centre, Queen Mary University of London, London, UK.
Rosa LegoodHealth Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.
Ertan SaridoganDepartment of Gynaecology, University College London Hospitals NHS Foundation Trust, London, UK.
W Glenn McCluggageDepartment of Pathology, Belfast Health and Social Care Trust, Belfast, UK.
Helen HansonSouth West Thames Regional Genetics Service, South West Thames Regional Genetic Services, London, UK.ORCID 0000-0002-3303-8713
Naveena SinghDepartment of Pathology, Barts Health NHS Trust, London, UK.
D Gareth EvansCentre for Genomic Medicine, University of Manchester, Manchester, UK.
Usha MenonMRC Clinical Trials Unit, University College London, London, UK.
Ranjit ManchandaWolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK r.manchanda@qmul.ac.uk.ORCID 0000-0003-3381-5057
PROTECTOR team
Queen Mary University of London · GBLondon School of Hygiene & Tropical Medicine · GBBarts Health NHS Trust · GBBelfast Health and Social Care Trust · GBMRC Clinical Trials Unit at UCL · GBUniversity College London Hospitals NHS Foundation Trust · GBUniversity of Manchester · GBWessex Regional Genetics Laboratory · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAcceptance of the role of the fallopian tube in 'ovarian' carcinogenesis and the detrimental sequelae of surgical menopause in premenopausal women following risk-reducing salpingo-oophorectomy (RRSO) has resulted in risk-reducing early-salpingectomy with delayed oophorectomy (RRESDO) being proposed as an attractive alternative risk-reducing strategy in women who decline/delay oophorectomy. We present the results of a qualitative study evaluating the decision-making process among

methodsIn-depth semistructured 1:1 interviews conducted using a predeveloped topic-guide (development informed by literature review and expert consultation) until informational saturation reached. Wording and sequencing of questions were left open with probes used to elicit additional information. All interviews were audio-recorded, transcribed verbatim, transcripts analysed using an inductive theoretical framework and data managed using NVIVO-v12.

resultsInformational saturation was reached following 24 interviews. Seven interconnected themes integral to surgical decision making were identified: fertility/menopause/cancer risk reduction/surgical choices/surgical complications/sequence of ovarian-and-breast prophylactic surgeries/support/satisfaction. Women for whom maximising ovarian cancer risk reduction was relatively more important than early menopause/quality-of-life preferred RRSO, whereas those more concerned about detrimental impact of menopause chose RRESDO. Women managed in specialist familial cancer clinic settings compared with non-specialist settings felt they received better quality care, improved hormone replacement therapy access and were more satisfied.

conclusionMultiple contextual factors (medical, physical, psychological, social) influence timing of risk-reducing surgeries. RRESDO offers women delaying/declining premenopausal oophorectomy, particularly those concerned about menopausal effects, a degree of ovarian cancer risk reduction while avoiding early menopause. Care of high-risk women should be centralised to centres with specialist familial gynaecological cancer risk management services to provide a better-quality, streamlined, holistic multidisciplinary approach.

Indexed as

Clinical Decision-MakingGenes, BRCA1Genes, BRCA2Prophylactic Surgical ProceduresSalpingectomySalpingo-oophorectomyAdultCohort StudiesFemaleHeterozygoteHumansMiddle AgedOvarian NeoplasmsOvariectomyPremenopauseProphylactic Mastectomygeneticsgynecologysurgical oncology

Identifiers

PMID33568437
PMCPMC8788252
OpenAlexW3115412626

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.