Evidence map›Paper›PMID 34972504›Full record

ArticleBMC women's health2021

Cost-Effectiveness of perioperative Vaginally Administered estrogen in postmenopausal women undergoing prolapse surgery (EVA trial): study protocol for a multicenter double-blind randomized placebo-controlled trial.

Eva V Vodegel, Sandra E Zwolsman, Astrid Vollebregt, Ruben G Duijnhoven, Judith E Bosmans, Leonie Speksnijder, Eveline J Roos, Wilbert Spaans, Franca Gerards, Albert Adriaanse and 17 more

Open access · goldAbstract readClinical Trial Protocol
In one paragraph

Article in BMC women's health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.9field-weighted citation impact, top 25% 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

3 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
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

27 authors at 20 institutions in 1 country.

Eva V VodegelDepartment of Obstetrics and Gynecology, Amsterdam University Medical Center - Location AMC, University of Amsterdam, Amsterdam, The Netherlands. e.v.vodegel@amsterdamumc.nl.ORCID 0000-0001-6897-9495
Sandra E ZwolsmanDepartment of Obstetrics and Gynecology, Amsterdam University Medical Center - Location AMC, University of Amsterdam, Amsterdam, The Netherlands.
Astrid VollebregtDepartment of Obstetrics and Gynecology, Spaarne Gasthuis, Hoofddorp, The Netherlands.
Ruben G DuijnhovenClinical Trials Unit of the Dutch Society for Obstetrics and Gynecology, Amsterdam, The Netherlands.
Judith E BosmansFaculty of Science, Health Economics and Health Technology Assessment, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Leonie SpeksnijderDepartment of Obstetrics and Gynecology, Amphia Ziekenhuis, Breda, The Netherlands.
Eveline J RoosDepartment of Obstetrics and Gynecology, Tergooi, Hilversum, The Netherlands.
Wilbert SpaansDepartment of Obstetrics and Gynecology, Maastricht University Medical Center, Maastricht, The Netherlands.
Franca GerardsDepartment of Obstetrics and Gynecology, Flevoziekenhuis, Almere, The Netherlands.
Albert AdriaanseDepartment of Obstetrics and Gynecology, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands.
Flora VernooijDepartment of Obstetrics and Gynecology, Diakonessenhuis, Utrecht, The Netherlands.
Alfredo L MilaniDepartment of Obstetrics and Gynecology, Reinier de Graaf Gasthuis, Delft, The Netherlands.
Marko SikkemaDepartment of Obstetrics and Gynecology, Ziekenhuisgroep Twente, Almelo, The Netherlands.
Mirjam WeemhoffDepartment of Obstetrics and Gynecology, Zuyderland Medisch Centrum, Heerlen, The Netherlands.
Marieke MousDepartment of Obstetrics and Gynecology, Alrijne Ziekenhuis, Leiderdorp, The Netherlands.
Anne DamoiseauxDepartment of Obstetrics and Gynecology, Catharina Ziekenhuis, Eindhoven, The Netherlands.
Heleen van DongenDepartment of Obstetrics and Gynecology, Groene Hart Ziekenhuis, Gouda, The Netherlands.
Marinus V/D PloegDepartment of Obstetrics and Gynecology, Martini Ziekenhuis, Groningen, The Netherlands.
Joggem VeenDepartment of Obstetrics and Gynecology, Maxima Medisch Centrum, Eindhoven, The Netherlands.
Geerte van de PolDepartment of Obstetrics and Gynecology, Gelre Ziekenhuis, Apeldoorn, The Netherlands.
Bart BroekmanDepartment of Obstetrics and Gynecology, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands.
Pieternel SteuresDepartment of Obstetrics and Gynecology, Jeroen Bosch Ziekenhuis, 's Hertogenbosch, The Netherlands.
Fernando Tjin-AsjoeDepartment of Obstetrics and Gynecology, Maasstad Ziekenhuis, Rotterdam, The Netherlands.
Jolande van der StegeDepartment of Obstetrics and Gynecology, Meander Medisch Centrum, Amersfoort, The Netherlands.
Ronald MouwDepartment of Obstetrics and Gynecology, Rijnstate, Arnhem, The Netherlands.
Carl H van der VaartDepartment of Obstetrics and Gynecology, University Medical Center Utrecht, Utrecht, The Netherlands.
Jan-Paul W R RooversDepartment of Obstetrics and Gynecology, Amsterdam University Medical Center - Location AMC, University of Amsterdam, Amsterdam, The Netherlands.
Amsterdam University Medical Centers · NLRadboud University Nijmegen · NLAlrijne Ziekenhuis · NLAmphia Ziekenhuis · NLBergman Clinics · NLDiakonessenhuis hospital · NLFlevoziekenhuis · NLGelre Hospitals · NLGroene Hart Ziekenhuis · NLJeroen Bosch Ziekenhuis · NLMaasstad Ziekenhuis · NLMaastricht University · NLMartini Ziekenhuis · NLMeander Medisch Centrum · NLNoordwest Ziekenhuisgroep · NLReinier de Graaf Hospital · NLRijnstate Hospital · NLSint Franciscus Gasthuis · NLSpaarne Ziekenhuis · NLTergooi · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSurgery for pelvic organ prolapse (POP) is associated with high recurrence rates. The costs associated with the treatment of recurrent POP are huge, and the burden from women who encounter recurrent POP, negatively impacts their quality of life. Estrogen therapy might improve surgical outcome for POP due to its potential beneficial effects. It is thought that vaginal estrogen therapy improves healing and long-term maintenance of connective tissue integrity. Hence, this study aims to evaluate the cost-effectiveness of perioperative vaginal estrogen therapy in postmenopausal women undergoing POP surgery.

methodsThe EVA trial is a multi-center double-blind randomized placebo-controlled trial conducted in the Netherlands comparing the effectiveness and costs-effectiveness of vaginal estrogen therapy. This will be studied in 300 postmenopausal women undergoing primary POP surgery, with a POP-Q stage of ≥ 2. After randomization, participants administer vaginal estrogen cream or placebo cream from 4 to 6 weeks preoperative until 12 months postoperative. The primary outcome is subjective improvement of POP symptoms at 1 year follow-up, measured with the Patient Global Impression of Improvement (PGI-I) scale. Secondary outcomes are POP-Q anatomy in all compartments, re-interventions, surgery related complications, general and disease specific quality of life, sexual function, signs and complaints of vaginal atrophy, vaginal pH, adverse events, costs, and adherence to treatment. Follow up is scheduled at 6 weeks, 6 months and 12 months postoperative. Data will be collected using validated questionnaires and out-patient visits including gynecological examination performed by an independent gynecologist. DISCUSSION: This study investigates whether perioperative vaginal estrogen will be cost-effective in the surgical treatment of POP in postmenopausal women. It is hypothesized that estrogen therapy will show a reduction in recurrent POP symptoms and a reduction in reoperations for POP, with subsequent improved quality of life among women and cost savings. Trial registrationNetherlands Trial Registry: NL6853; registered 19-02-2018, https://www.trialregister.nl/trial/6853 . EudraCT: 2017-003144-21; registered: 24-07-2017.

Indexed as

Pelvic Organ ProlapseQuality of LifeCost-Benefit AnalysisEstrogensFemaleGynecologic Surgical ProceduresHumansMulticenter Studies as TopicPostmenopauseRandomized Controlled Trials as TopicTreatment OutcomeEstrogensCost-effectivenessPelvic organ prolapsePelvic reconstructive surgeryPostmenopausalRecurrenceVaginal estrogen therapyWound healing

Identifiers

PMID34972504
PMCPMC8720212
OpenAlexW4205850468

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.