{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T01:43:09Z","timestamp":1793497389123,"version":"4.5.0"},"reference-count":19,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2013,7,22]],"date-time":"2013-07-22T00:00:00Z","timestamp":1374451200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2013,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine which doctor\u2010 and patient\u2010related factors affect failure of outpatient endometrial sampling in women with postmenopausal bleeding, and to develop a multivariable prediction model to select women with a high probability of failed sampling.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Prospective multicenter cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Three teaching hospitals in the Netherlands.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Women presenting with postmenopausal bleeding with an indication for endometrial sampling.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Multivariable logistic regression was performed to evaluate the impact of doctor's training level and patient's characteristics on failure of sampling.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Failure of endometrial sampling, classified as technical failure or insufficient tissue for diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In 74 (20.8%) of the 356 included women, sampling technically failed, and in 84 (29.8%) the amount of tissue was insufficient for diagnosis. Nulliparity [odds ratio (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>) 3.8, 95% confidence interval (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) 1.8\u20137.9] and advanced age (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 1.03 per year, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.00\u20131.06) were associated with technical failure. Advanced age was associated with insufficient sampling (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 1.04 per year, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.01\u20131.07), and endometrial thickness &gt;12\u00a0mm decreased the chance of insufficient sampling (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 0.3, 95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.1\u20130.8). The prediction model for total failure had an area under the <jats:styled-content style=\"fixed-case\">ROC<\/jats:styled-content> curve of 0.64 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.58\u20130.70).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In women with postmenopausal bleeding, the failure rate of endometrial sampling is relatively high and is associated with nulliparity and advanced age. Endometrial thickness &gt;12\u00a0mm decreased the chance of failure. A multivariable prediction model for total failure based on patient characteristics has a moderate capacity to discriminate between women at high or low risk of failure.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.12212","type":"journal-article","created":{"date-parts":[[2013,7,1]],"date-time":"2013-07-01T06:46:43Z","timestamp":1372661203000},"page":"1216-1222","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["Factors attributing to the failure of endometrial sampling in women with postmenopausal bleeding"],"prefix":"10.1111","volume":"92","author":[{"given":"Nicole C.M.","family":"Visser","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology TweeSteden Hospital Tilburg the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria C.","family":"Breijer","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Albert Schweitzer Hospital Dordrecht the Netherlands"},{"name":"Department of Obstetrics and Gynecology Academic Medical Center Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malou C.","family":"Herman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Maxima Medical Center Veldhoven the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruud L.M.","family":"Bekkers","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Radboud University Nijmegen Medical Center Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastiaan","family":"Veersema","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology St. Antonius Hospital Nieuwegein the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brent C.","family":"Opmeer","sequence":"additional","affiliation":[{"name":"Clinical Research Unit Academic Medical Center Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben W.J.","family":"Mol","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Academic Medical Center Amsterdam the Netherlands"},{"name":"Department of Obstetrics and Gynecology Maxima Medical Center Veldhoven the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Timmermans","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Academic Medical Center Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna M.A.","family":"Pijnenborg","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology TweeSteden Hospital Tilburg the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,7,22]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/014436104100009394"},{"key":"e_1_2_9_3_1","unstructured":"Nederlandse Vereniging voor Obstetrie en Gynaecologie. 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