Table 1 Study characteristics and methodological quality.
Bleeding type / Menopausal status (%) | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|
Study (Year published) | Details | Delay (hours) | Patient selection | Post | HRT | Pre | †Other | Reference standard | Blinding of results | Study quality level |
IMMEDIATE VERIFICATION (</=24 HOURS) (16 studies) | ||||||||||
Endometrial biopsy studies (8) | ||||||||||
Sun-Kuie et al. [15] (1992) | Gynoscann® | Day before | Unreported | *5 (11) | - | 41 (89) | - | D&C | Unreported | I |
Goldberg et al. [16] (1981) | Accurette® | Immediate | Unreported | 30 (100) | - | - | D&C | Unreported | II | |
Sonnendecker et al. [17] (1981) | Accurette® | Immediate | Unreported | *6 (24) | - | 17 (76) | - | D&C | Unreported | I |
Kufahl et al. [18] (1997) | Explora® | Immediate | Consecutive | *33 (21) | - | 125 (79) | - | Hysterectomy | Unreported | I |
Kufahl et al. [18] (1997) | Gynoscann® | Immediate | Consecutive | *36 (21) | - | 133 (79) | - | Hysterectomy | Unreported | I |
Goldschmit et al. [19] (1993) | Pipelle® | Immediate | Consecutive | *34 (23) | - | 115 (77) | - | D&C | Yes | I |
Kavak et al. [20] (1996) | Pipelle® | Immediate | Unreported | *34 (56) | - | 27 (44) | - | D&C | Yes | I |
Goldberg et al. [16] (1981) | Vabra Aspirator® | Immediate | Unreported | 31 (100) | - | - | - | D&C | Unreported | II |
Ultrasound scan studies (8) | ||||||||||
Botsis et al. [21] (1992) | ≤ 4 mm DL | Day before | Unreported | 120(100) | - | - | - | D&C | Unreported | II |
Garuti et al. [22] (1999) | ≤ 4 mm DL | Immediate | Unreported | 368 (88) | 51 (12) | - | - | D&C | Unreported | I |
Haller et al. [23](1996) | ≤ 4 mm DL | Day before | Unreported | 81 (100) | - | - | - | D&C | Unreported | II |
Grigoriou et al. [24] (1996) | ≤ 5 mm DL | Day before | Unreported | 250(100) | - | - | - | D&C | Unreported | II |
Karlsson et al. [25](1993) | ≤ 5 mm DL | Day before | Unreported | 103(100) | - | - | - | D&C | Unreported | II |
Malinova et al. [26] (1996) | ≤ 5 mm DL | Day before | Unreported | 154(100) | - | - | - | D&C | Unreported | II |
Wolman et al. [27] (1996) | ≤ 5 mm DL | Immediate | Unreported | 54 (100) | - | - | - | D&C | Unreported | II |
Malinova et al. [28] (1995) | ≤ 5 mm SL | Day before | Unreported | 118(100) | - | - | - | D&C | Unreported | II |
DELAYED VERIFICATION (> 24 HOURS) (11 studies) | ||||||||||
Endometrial biopsy studies (4) | ||||||||||
Stovall et al. [29] (1989) | Novak Curette® | Unreported | Unreported | - | - | - | 165(100) NS | Hysterectomy | Unreported | II |
Krampl et al. [3] (1997) | Pipelle® | < 6 months | Unreported | 37 (12) | - | 247 (77) | 35 (11) | TCRE/Hysterectomy | Unreported | I |
Gupta et al. [30] (1996) | Pipelle® | < 1 month | Unreported | 54 (100) | - | - | D&C | Unreported | II | |
Stovall et al. [29] (1989) | Vabra Aspirator® | Unreported | Unreported | - | - | - | 62 (100) NS | Hysterectomy | Unreported | II |
Ultrasound scan studies (7) | ||||||||||
Guner et al. [31](1996) | ≤ 4 mm DL | </= 7 days | Unreported | 192(100) | - | - | - | D&C | Unreported | II |
Abu-Ghazzeh et al. [32] (1999) | ≤ 5 mm DL | 1 week | Unreported | 98 (100) | - | - | - | D&C | Unreported | II |
DeSilva et al. [33] (1997) | ≤ 5 mm DL | < 4 weeks | Consecutive | 44 (88) | 6 (12) | - | - | D&C | Unreported | I |
Gupta et al. [30] (1996) | ≤ 5 mm DL | < 1 month | Unreported | 75 (100) | - | - | - | D&C | Yes | I |
Taviani et al. [34] (1995) | ≤ 5 mm DL | 1 week | Unreported | 41 (100) | - | - | - | D&C | Unreported | II |
Moreles et al. [35] (1998) | ≤ 6 mm DL | < 3 weeks | Unreported | 200(100) | - | - | - | D&C | Unreported | II |
Mortakis et al. [36] (1997) | ≤ 3 mm SL | < 4 weeks | Unreported | 78 (100) | - | - | - | D&C | Unreported | II |