Related Experiment Videos
Diagnostic dilatation and curettage: is it used appropriately?
A Coulter1, A Klassen, I Z MacKenzie
1Department of Public Health and Primary Care, University of Oxford, Radcliffe Infirmary.
BMJ (Clinical Research Ed.)
|January 23, 1993
Summary
Dilatation and curettage (D&C) rates in Britain remained stable while declining dramatically in the United States. Significant variations in D&C usage highlight potential overuse and the need for standardized guidelines.
Area of Science:
- Gynecology
- Health Services Research
- Epidemiology
Background:
- Dilatation and curettage (D&C) is a common gynecological procedure.
- International and national variations in D&C utilization suggest differing clinical practices.
Purpose of the Study:
- To compare D&C usage patterns between Britain and the United States.
- To investigate variations in D&C utilization within a UK regional health authority.
Main Methods:
- Analysis of routinely collected hospital inpatient statistics.
- Inclusion of all inpatient D&C episodes, excluding pregnancy-related cases.
- Data sourced from England, Scotland, the United States, and the Oxford region.
Main Results:
- British D&C rates were stable (1977-1990), while US rates declined significantly.
- In 1989-90, England's rate was 71.1/10,000 women vs. America's 10.8/10,000.
- Wide variations in D&C use were observed within the Oxford region, including among women under 40.
Conclusions:
- The study suggests potential inappropriate use of D&C.
- Variations in D&C utilization indicate differing perceptions of appropriateness, warranting audit.
- Developing guidelines for appropriate D&C use and alternatives could lead to cost savings and patient benefits.