{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T22:06:49Z","timestamp":1772489209211,"version":"3.50.1"},"reference-count":20,"publisher":"BMJ","issue":"4","funder":[{"DOI":"10.13039\/501100000664","name":"Health Technology Assessment Programme","doi-asserted-by":"publisher","award":["11\/114\/01"],"award-info":[{"award-number":["11\/114\/01"]}],"id":[{"id":"10.13039\/501100000664","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2016,3,17]]},"published-print":{"date-parts":[[2016,4]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Conduct an economic evaluation based on best currently available evidence comparing alternative treatments levonorgestrel-releasing intrauterine system, depot-medroxyprogesterone acetate, combined oral contraceptive pill (COCP) and \u2018no treatment\u2019 to prevent recurrence of endometriosis after conservative surgery in primary care, and to inform the design of a planned trial-based economic evaluation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We developed a state transition (Markov) model with a 36-month follow-up. The model structure was informed by a pragmatic review and clinical experts. The economic evaluation adopted a UK National Health Service perspective and was based on an outcome of incremental cost per quality-adjusted life year (QALY). As available data were limited, intentionally wide distributions were assigned around model inputs, and the average costs and outcome of the probabilistic sensitivity analyses were reported.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>On average, all strategies were more expensive and generated fewer QALYs compared to no treatment. However, uncertainty attributing to the transition probabilities affected the results. Inputs relating to effectiveness, changes in treatment and the time at which the change is made were the main causes of uncertainty, illustrating areas where robust and specific data collection is required.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>There is currently no evidence to support any treatment being recommended to prevent the recurrence of endometriosis following conservative surgery. The study highlights the importance of developing decision models at the outset of a trial to identify data requirements to conduct a robust post-trial analysis.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2015-010580","type":"journal-article","created":{"date-parts":[[2016,4,15]],"date-time":"2016-04-15T23:13:55Z","timestamp":1460762035000},"page":"e010580","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Pharmaceutical treatments to prevent recurrence of endometriosis following surgery: a model-based economic evaluation"],"prefix":"10.1136","volume":"6","author":[{"given":"Sabina","family":"Sanghera","sequence":"first","affiliation":[{"name":"Health Economics Unit, University of Birmingham, Birmingham, UK"},{"name":"School of Social and Community Medicine, University of Bristol, Bristol, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pelham","family":"Barton","sequence":"additional","affiliation":[{"name":"Health Economics Unit, University of Birmingham, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siladitya","family":"Bhattacharya","sequence":"additional","affiliation":[{"name":"School of Medicine and Dentistry, University of Aberdeen, Aberdeen, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew W","family":"Horne","sequence":"additional","affiliation":[{"name":"MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tracy Elizabeth","family":"Roberts","sequence":"additional","affiliation":[{"name":"Health Economics Unit, University of Birmingham, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2016,4,15]]},"reference":[{"key":"2025101813110596000_6.4.e010580.1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dei135"},{"key":"2025101813110596000_6.4.e010580.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0889-8545(05)70302-8"},{"key":"2025101813110596000_6.4.e010580.3","unstructured":"ESHRE\u2014European Society of Human Reproduction and Embryology. Management of women with endometriosis. ESHRE Guideline development group. 2013. http:\/\/www.eshre.eu\/~\/media\/Files\/ESHRE%20guideline%20on%20endometriosis%202013%20v1.pdf"},{"key":"2025101813110596000_6.4.e010580.4","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/det284"},{"key":"2025101813110596000_6.4.e010580.5","doi-asserted-by":"publisher","DOI":"10.1097\/01.gco.0000136496.95075.79"},{"key":"2025101813110596000_6.4.e010580.6","doi-asserted-by":"crossref","unstructured":"Abou-Setta AM , Al-Inany HG , Farquhar CM . Levonorgestrel-releasing intrauterine device (LNG-IUD) for symptomatic endometriosis following surgery. Cochrane Database Syst Rev 2006;(4):CD005072. doi:10.1002\/14651858.CD005072.pub2","DOI":"10.1002\/14651858.CD005072.pub2"},{"key":"2025101813110596000_6.4.e010580.7","unstructured":"Daniels JP , Clark TJ , Bhattacharya S . BSGE Survey of current post-operative hormonal treatment for Endometriosis. 2012."},{"key":"2025101813110596000_6.4.e010580.8","doi-asserted-by":"publisher","DOI":"10.1002\/hec.1093"},{"key":"2025101813110596000_6.4.e010580.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2011.05.090"},{"key":"2025101813110596000_6.4.e010580.10","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dei290"},{"key":"2025101813110596000_6.4.e010580.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2007.01.053"},{"key":"2025101813110596000_6.4.e010580.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2010.08.042"},{"key":"2025101813110596000_6.4.e010580.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2011.01.027"},{"key":"2025101813110596000_6.4.e010580.14","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31824264c3"},{"key":"2025101813110596000_6.4.e010580.15","doi-asserted-by":"crossref","unstructured":"Briggs A , Claxton K , Sculpher M . Decision modelling in health economic evaluation. Oxford: Oxford University Press, 2006.","DOI":"10.1093\/oso\/9780198526629.001.0001"},{"key":"2025101813110596000_6.4.e010580.16","doi-asserted-by":"crossref","first-page":"e91891","DOI":"10.1371\/journal.pone.0091891","article-title":"Levonorgestrel-releasing intrauterine system vs. usual medical treatment for menorrhagia: an economic evaluation alongside a randomised controlled trial","volume":"9","author":"Sanghera","year":"2014","journal-title":"PLoS ONE"},{"key":"2025101813110596000_6.4.e010580.17","unstructured":"Curtis L . Unit costs of health and social care. Personal Social Service Research Unit, 2013."},{"key":"2025101813110596000_6.4.e010580.18","unstructured":"Joint Formulary Committee. British National Formulary 66. BMJ Group & Pharmaceutical Press, 2013."},{"key":"2025101813110596000_6.4.e010580.19","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d2202"},{"key":"2025101813110596000_6.4.e010580.20","unstructured":"National Institute of Health and Clinical Excellence. Guide to the methods of technology appraisal. London: National Institute of Health and Clinical Excellence, 2008."}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2015-010580","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T20:11:13Z","timestamp":1760818273000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2015-010580"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,4]]},"references-count":20,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2016,4,15]]},"published-print":{"date-parts":[[2016,4]]}},"alternative-id":["10.1136\/bmjopen-2015-010580"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2015-010580","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,4]]}}}