Regional practice variation in hysterectomy and the implementation of less invasive surgical procedures: A register-based study in the Netherlands.

Introduction: Many women experience bleeding disorders that may have an anatomical or unexplained origin. Although hysterectomy is the most definitive and common treatment, it is highly invasive and resource-intensive. Less invasive therapies are therefore advised before hysterectomy for women with fibroids or bleeding disorders.

Practice variation in the stepped care approach to idiopathic heavy menstrual bleeding: A population-based study.

Introduction: Heavy menstrual bleeding (HMB) affects a quarter of all women, with half having no structural cause. Dutch guidelines recommend a stepped care approach to the management of such idiopathic HMB, starting with medication or a levonorgestrel-releasing intrauterine device (LNG-IUD), before progressing to endometrial ablation, and ultimately, hysterectomy. However, practice variation between hospitals could lead to suboptimal health outcomes and increased healthcare costs for some women.

Laparoscopic sacrocolpopexy versus abdominal sacrocolpopexy for vaginal vault prolapse: long-term follow-up of a randomized controlled trial.

Introduction And Hypothesis: The objective of this study was to evaluate long-term outcomes of laparoscopic sacrocolpopexy (LSC) versus abdominal sacrocolpopexy (ASC) for vaginal vault prolapse (VVP).

Methods: Long-term follow-up of a multicenter randomized controlled trial (SALTO trial). A total of 74 women were randomly assigned to LSC (n=37) or ASC (n=37).

Design characteristics of studies on medical practice variation of caesarean section rates: a scoping review.

Background: Medical practice variation in caesarean section rates is the most studied type of practice variation in the field of obstetrics and gynaecology. This has not resulted in increased homogeneity of treatment between geographic areas or healthcare providers. Our study aim was to evaluate whether current study designs on medical practice variation of caesarean section rates were optimized to identify the unwarranted share of practice variation and could contribute to the reduction of unwarranted practice variation by meeting criteria for audit and feedback.

[Translating care evaluations into practice: a suggestion based on the healthcare professional's intrinsic motivation to improve].

Scientific medical associations have made important steps in setting up integrated research agendas to narrow the huge knowledge gap about the effectiveness of accepted treatments. The ensuing care evaluations provide new insight into the value of different treatments; however, the implementation of the results of these care evaluations in practice continues to lag behind. In 2016 the Netherlands health insurers and the Netherlands patients' federation, supported by the Netherlands federation of medical specialists, started up the programme 'Leading the change'.