Re: study

[Guest guest]

O.K. Truce,

I apologize for offending people. I just feel strongly that UAE and

myomectomy are not risk free procedures. It seems so cold and impersonal to

devoid people arbitrarily for something that is a very personal and

individual decision. I have seen frightening information from the HERS

foundation about what can happen if things go wrong and this taints my

opinion. In any case, it's just my opinion. Everyone must follow their own

road and do what seems right to them. I'm off my horse on this one, now.

Tish

[Guest guest]

>I apologize for offending people. I just feel strongly that UAE and

>myomectomy are not risk free procedures. It seems so cold and impersonal to

>devoid people arbitrarily for something that is a very personal and

>individual decision. I have seen frightening information from the HERS

>foundation about what can happen if things go wrong and this taints my

>opinion. In any case, it's just my opinion. Everyone must follow their own

>road and do what seems right to them. I'm off my horse on this one, now.

>

>Tish

Tish,

I didn't find your posts offensive. I put the original question out to the

group because I was extremely curious about what the range of

emotions/responses would be to this issue. You are perfectly correct in

stating that UAE and myomectomy are not risk free procedures. However,

clinical trials are not put in place to force specific options on any one

person/groups of people. They are voluntary. And, oftentimes (although not

always), they present a standard of care to patients that is above and

beyond the norm.

In any clinical trial things can and do go wrong, however. The Women's

Health Initiative originally started out with an arm of studying unopposed

estrogen replacement therapy (no progesterone) for menopausal women who

still had their cervix that had to be abandoned because of the high rate of

cervical cancer that is the result of this kind of unopposed administration

of estrogen. Would you believe that there were women who didn't want to

discontinue the trial?

In trying to advance the knowledge base we have for uterine fibroid

embolization, interventional radiologists are faced with a very difficult

road to travel down. Gynecologists control the keys to the doorway that

will allow women to walk freely toward a referral for UFE. And those gyns

are holding on tightly to those keys and demanding more evidence. It's a

catch-22. To get evidence, you need patients. To get patients, you need

gyns to open the door and refer women. To get gyns to open the door, you

need evidence. But you can't get evidence because you don't have the

patients. In the end, the status quo is maintained and another 600,000

women undergo hysterectomy as another year passes by (177,000 - 366,000 for

uterine fibroids alone). I don't know. In the " scheme of things " which do

you think is worse -- 1,000 women volunteering for randomization of

myomectomy/UFE or 600,000 women undergoing hysterectomy because they have no

other option presented to them?

I don't know. Maybe I've " sold out " to the medical community in this

regard. But I keep trying to look at both sides of the coin both

emotionally and logically and still keep coming up with it being something

that I would support. Evidence is good. I want evidence. I want to know

if the real menopause ratio for post UFE patients is 2%, 10%, or 25% and I'm

ever so grateful that Dr. Spies is tracking FSH levels pre and post

UFE in his trials to find the answer to this question. I want to be

prepared for the realities of the choices I make and not just the

stab-in-the-dark guesses that are so freely handed out with a shrug of the

shoulders.

The question is, how do doctors collect the evidence? And, would I have

been desperate enough to undergo randomization for myomectomy/UFE to avoid

hysterectomy? My answer is yes. But, am I way out of the norm because of

the level of desperation that I had reached? Or, are there other women who

would volunteer for this type of randomization? I don't know the answer to

this and neither do the doctors who are trying to put together their

clinical trial protocols. Ultimately, if women do not volunteer, the trial

is cancelled/withdrawn. So, in the end, we DO have some control over the

type of studies that are done.

Discussion of this topic is healthy and should be regarded/acknowledged as

something that is okay to disagree upon. Doctors listening in on our

conversations (yes, there are a few) won't know how we really feel on the

subject if we squash our emotional ties to our responses for fear of

offending others. (Personal attacks, of course, are always unwelcome.)

Hopefully, we can healthily disagree and present our personal reasons for

the disagreement in a way that is understood by others and respected as

being the personal opinion of the individual -- simply brought to the table

based on their very own, very individual, personal experiences in this life

with their own health, doctors, family, circumstances, cultural beliefs,

etc.

Keep posting Tish. All views are welcome on this list group when presented

within the individual's personal perspective.

Carla Dionne

mailto:cdionne@...

http://www.uterinefibroids.com

member, /list/uterinefibroids

[Guest guest]

>I apologize for offending people. I just feel strongly that UAE and

>myomectomy are not risk free procedures. It seems so cold and impersonal to

>devoid people arbitrarily for something that is a very personal and

>individual decision. I have seen frightening information from the HERS

>foundation about what can happen if things go wrong and this taints my

>opinion. In any case, it's just my opinion. Everyone must follow their own

>road and do what seems right to them. I'm off my horse on this one, now.

>

>Tish

Tish,

I didn't find your posts offensive. I put the original question out to the

group because I was extremely curious about what the range of

emotions/responses would be to this issue. You are perfectly correct in

stating that UAE and myomectomy are not risk free procedures. However,

clinical trials are not put in place to force specific options on any one

person/groups of people. They are voluntary. And, oftentimes (although not

always), they present a standard of care to patients that is above and

beyond the norm.

In any clinical trial things can and do go wrong, however. The Women's

Health Initiative originally started out with an arm of studying unopposed

estrogen replacement therapy (no progesterone) for menopausal women who

still had their cervix that had to be abandoned because of the high rate of

cervical cancer that is the result of this kind of unopposed administration

of estrogen. Would you believe that there were women who didn't want to

discontinue the trial?

In trying to advance the knowledge base we have for uterine fibroid

embolization, interventional radiologists are faced with a very difficult

road to travel down. Gynecologists control the keys to the doorway that

will allow women to walk freely toward a referral for UFE. And those gyns

are holding on tightly to those keys and demanding more evidence. It's a

catch-22. To get evidence, you need patients. To get patients, you need

gyns to open the door and refer women. To get gyns to open the door, you

need evidence. But you can't get evidence because you don't have the

patients. In the end, the status quo is maintained and another 600,000

women undergo hysterectomy as another year passes by (177,000 - 366,000 for

uterine fibroids alone). I don't know. In the " scheme of things " which do

you think is worse -- 1,000 women volunteering for randomization of

myomectomy/UFE or 600,000 women undergoing hysterectomy because they have no

other option presented to them?

I don't know. Maybe I've " sold out " to the medical community in this

regard. But I keep trying to look at both sides of the coin both

emotionally and logically and still keep coming up with it being something

that I would support. Evidence is good. I want evidence. I want to know

if the real menopause ratio for post UFE patients is 2%, 10%, or 25% and I'm

ever so grateful that Dr. Spies is tracking FSH levels pre and post

UFE in his trials to find the answer to this question. I want to be

prepared for the realities of the choices I make and not just the

stab-in-the-dark guesses that are so freely handed out with a shrug of the

shoulders.

The question is, how do doctors collect the evidence? And, would I have

been desperate enough to undergo randomization for myomectomy/UFE to avoid

hysterectomy? My answer is yes. But, am I way out of the norm because of

the level of desperation that I had reached? Or, are there other women who

would volunteer for this type of randomization? I don't know the answer to

this and neither do the doctors who are trying to put together their

clinical trial protocols. Ultimately, if women do not volunteer, the trial

is cancelled/withdrawn. So, in the end, we DO have some control over the

type of studies that are done.

Discussion of this topic is healthy and should be regarded/acknowledged as

something that is okay to disagree upon. Doctors listening in on our

conversations (yes, there are a few) won't know how we really feel on the

subject if we squash our emotional ties to our responses for fear of

offending others. (Personal attacks, of course, are always unwelcome.)

Hopefully, we can healthily disagree and present our personal reasons for

the disagreement in a way that is understood by others and respected as

being the personal opinion of the individual -- simply brought to the table

based on their very own, very individual, personal experiences in this life

with their own health, doctors, family, circumstances, cultural beliefs,

etc.

Keep posting Tish. All views are welcome on this list group when presented

within the individual's personal perspective.

Carla Dionne

mailto:cdionne@...

http://www.uterinefibroids.com

member, /list/uterinefibroids

[Guest guest]

Dear Carla,

Thank you for your reply. I believe the situation for women, with

respect to medical care, is quite sad and that women are made to suffer from

it in so many ways. I am very sensitive to the moral and ethical

implications of much of what happens in the medical community. I wish that

we as a society took more care to respect the dignity of life and the value

of each person (especially women). I still believe that there are more

humane ways to obtain a good answer to these questions. I don't think you

would have posed this question had there not been an ethical dilemma in it.

Sincerely,

Tish

[Guest guest]

Dear Carla,

Thank you for your reply. I believe the situation for women, with

respect to medical care, is quite sad and that women are made to suffer from

it in so many ways. I am very sensitive to the moral and ethical

implications of much of what happens in the medical community. I wish that

we as a society took more care to respect the dignity of life and the value

of each person (especially women). I still believe that there are more

humane ways to obtain a good answer to these questions. I don't think you

would have posed this question had there not been an ethical dilemma in it.

Sincerely,

Tish

[Guest guest]

> Thank you for your reply. I believe the situation for women, with

>respect to medical care, is quite sad and that women are made to suffer

from

>it in so many ways. I am very sensitive to the moral and ethical

>implications of much of what happens in the medical community. I wish that

>we as a society took more care to respect the dignity of life and the value

>of each person (especially women). I still believe that there are more

>humane ways to obtain a good answer to these questions. I don't think you

>would have posed this question had there not been an ethical dilemma in it.

Tish,

I didn't pose the question on clinical trials with myo/UFE because of any

ethical concerns I have. I personally don't see any ethical dilemma in this

particular kind of study as both options -- myo and UFE -- are good ones and

either would have been acceptable to me. But I did want to know if others

would feel differently and, perhaps, find ethical dilemma in the study.

Your answer clearly told us that you did and I dare say that there are

probably others who would agree with you just as there were others that

agree with me. Neither of us are " wrong " for thinking or feeling the way we

do. More than likely, we simply bring a different set of " cards " to the

table for coming to our differing conclusions.

A doctor that I know has just received grant monies for doing a RCT

(randomized controlled trial) and is trying to decide what kind of control

group to compare UFE to. Right now, there are DOZENS of studies going on

across the country comparing UFE to myo, hyst, Lupron, etc. I think I've

convinced him that Lupron (or ANY drug therapy) is NOT the way to go

(something that pharmaceuticals push and could mean even more money for

studies) and now he's looking at other options. As a physician, he is

sincerely interested in finding out whether or not women would participate

in this kind of trial (randomized myo/UFE). He did not want to set up his

protocol in a vacuum, so to speak, as he cares about his patients a great

deal and does not want to hurt anyone. Your response, which was very real,

and Leonie's response probably represents the 2 ends of the spectrum. When

doctors embark down roads of experimentation, I think they need to know how

their travels are going to be received. Which is the real reason I posed

the question.

Carla Dionne

mailto:cdionne@...

http://www.uterinefibroids.com

member, /list/uterinefibroids

[Guest guest]

> Thank you for your reply. I believe the situation for women, with

>respect to medical care, is quite sad and that women are made to suffer

from

>it in so many ways. I am very sensitive to the moral and ethical

>implications of much of what happens in the medical community. I wish that

>we as a society took more care to respect the dignity of life and the value

>of each person (especially women). I still believe that there are more

>humane ways to obtain a good answer to these questions. I don't think you

>would have posed this question had there not been an ethical dilemma in it.

Tish,

I didn't pose the question on clinical trials with myo/UFE because of any

ethical concerns I have. I personally don't see any ethical dilemma in this

particular kind of study as both options -- myo and UFE -- are good ones and

either would have been acceptable to me. But I did want to know if others

would feel differently and, perhaps, find ethical dilemma in the study.

Your answer clearly told us that you did and I dare say that there are

probably others who would agree with you just as there were others that

agree with me. Neither of us are " wrong " for thinking or feeling the way we

do. More than likely, we simply bring a different set of " cards " to the

table for coming to our differing conclusions.

A doctor that I know has just received grant monies for doing a RCT

(randomized controlled trial) and is trying to decide what kind of control

group to compare UFE to. Right now, there are DOZENS of studies going on

across the country comparing UFE to myo, hyst, Lupron, etc. I think I've

convinced him that Lupron (or ANY drug therapy) is NOT the way to go

(something that pharmaceuticals push and could mean even more money for

studies) and now he's looking at other options. As a physician, he is

sincerely interested in finding out whether or not women would participate

in this kind of trial (randomized myo/UFE). He did not want to set up his

protocol in a vacuum, so to speak, as he cares about his patients a great

deal and does not want to hurt anyone. Your response, which was very real,

and Leonie's response probably represents the 2 ends of the spectrum. When

doctors embark down roads of experimentation, I think they need to know how

their travels are going to be received. Which is the real reason I posed

the question.

Carla Dionne

mailto:cdionne@...

http://www.uterinefibroids.com

member, /list/uterinefibroids

[Guest guest]

What is the point of a RCT in this case? They are often done when the

treatments are indistinguishable of the surface, and the results

substantially subjective in order to assign individuals in a double

blind studies. Neither the doctor nor the patient knows which

treatment anyone is receiving, so subjective expected results and side

effects can be determined without expectation bias. (The tamoxifen

studies for premenopausal women at high risk for breast cancer is one

example.)

It seems to me that at this point, randomization is not necessary and

wouldn't be particularly helpful. There isn't the possibility of a

double blind study and there are enough objective characteristics

(size, location, number of fibroids, amount of bleeding, etc.) that you

could pair/group similar individuals for accurate objective evaluation

of results, which would be measured using the same objective standards

as were used to pair the individuals/groups initially.

The only reason I could see for randomization is if there were not

enough women interested in one or the other treatment option to gather

a comparison group. If that is the case, it does strike me as a bit

coercive - you can have the option of a UAE but only if you're willing

to risk undergoing a myo first (or vice versa)

> A doctor that I know has just received grant monies for doing a RCT

> (randomized controlled trial) and is trying to decide what kind of

control

> group to compare UFE to.

> Carla Dionne

>

[Guest guest]

What is the point of a RCT in this case? They are often done when the

treatments are indistinguishable of the surface, and the results

substantially subjective in order to assign individuals in a double

blind studies. Neither the doctor nor the patient knows which

treatment anyone is receiving, so subjective expected results and side

effects can be determined without expectation bias. (The tamoxifen

studies for premenopausal women at high risk for breast cancer is one

example.)

It seems to me that at this point, randomization is not necessary and

wouldn't be particularly helpful. There isn't the possibility of a

double blind study and there are enough objective characteristics

(size, location, number of fibroids, amount of bleeding, etc.) that you

could pair/group similar individuals for accurate objective evaluation

of results, which would be measured using the same objective standards

as were used to pair the individuals/groups initially.

The only reason I could see for randomization is if there were not

enough women interested in one or the other treatment option to gather

a comparison group. If that is the case, it does strike me as a bit

coercive - you can have the option of a UAE but only if you're willing

to risk undergoing a myo first (or vice versa)

> A doctor that I know has just received grant monies for doing a RCT

> (randomized controlled trial) and is trying to decide what kind of

control

> group to compare UFE to.

> Carla Dionne

>

[Guest guest]

>The only reason I could see for randomization is if there were not

>enough women interested in one or the other treatment option to gather

>a comparison group. If that is the case, it does strike me as a bit

>coercive - you can have the option of a UAE but only if you're willing

>to risk undergoing a myo first (or vice versa)

I was following you pretty good until I got to this " coercive "

statement. How does a voluntary trial that people must pick up the phone

and avail themselves personally of their own free will become " coercive " in

your eyes? Certainly those same people could very well avail themselves of

a specifically chosen procedure with the physician of their choice without

ever entering a trial, could they not?

I suppose you could argue that insurance companies that are denying coverage

for this procedure might make desperate women enter just such a trial to

*potentially* get the procedure.

But the gyn " standard of care " for uterine fibroids is hysterectomy. And

surely that IS covered by their insurance.

I've read email where women HAVE allowed the treatment decision for their

uterine fibroids to be made entirely by what is covered by their insurance.

To them, UFE is a " nice to have " not a " got to have " when the dollars and

cents boil down to the reality of what a person can afford, care to take the

time to push their insurance for payout, or even trouble themselves with

thinking about. Quite frankly, the 10% plus $500 annual deductible has been

a bit of a hardship for me. Especially when the bills started stacking up.

.. .eventually surpassing $50k. And I didn't have any trouble at all with

insurance coverage. Just with paying " my share " of a gargantuan bill. I

can't imagine my making this choice if I were any less capable, financially,

of being able to pay my way out of this paper bag. It simply wouldn't be an

option and I would continue suffering with my fibroids. And that would be

MY choice when others would go ahead and have a hysterectomy.

Life sucks and reality is what it is. UFE is not the only procedure that

some insurance policies do not cover. Many, many people are barely hanging

on to the minimal care that they receive based on what is covered under

their policies for a variety of conditions. Some people never fill medical

prescriptions because they can't afford to. I know this is way off track

here, but I'm truly stuggling with trying to find a connection to what makes

a volunteer act " coercive " .

Ability to afford the treatment option of choice is the only angle that I

could come up with in terms of a RCT being deemed " coercive " . Did you have

something else in mind? I feel like maybe I'm " missing the point " entirely

here. Medicine is either a stab in the dark and " your guess is as good as

mine " OR it's based on science and, hopefully, evidence. Just how DO we go

from basing treatments on " guesses " to basing them on " science " ? How do you

cross that bridge without somebody becoming the guinea pig?

The closest I can get to what you are trying to say about an RCT being

" coercive " has to do with my own experience of sexual dysfunction post UFE.

Uterine contractions are gone. Lovely, wonderful internal, cervical orgasms

are gone. I was given the opportunity to join the Viagra study in Boston.

I read the protocol. I turned it down. It wasn't something that I,

personally, was comfortable with doing. My choice. I had the opportunity

of a potentially helpful solution and turned it down in lieu of what?

Retaining the status quo. Did I deem their study requirements " coercive " ?

No. Just not something I cared to participate in at this time.

Okay. This babbling brook needs to get some exercise and see if there are

any REAL brain cells left from today's busy workload. I've just re-read

this email and feel that I've inflicted y'all with a bunch of unnecessary

gibberish. Sorry. I'll come back in a couple of days when I'm not so tired

and can think more clearly.

Carla Dionne

mailto:cdionne@...

http://www.uterinefibroids.com

member, /list/uterinefibroids

[Guest guest]

Carla Dione wrote:

Certainly those same people could very well avail themselves of

>a specifically chosen procedure with the physician of their choice without

>ever entering a trial, could they not?

In a nutshell - no, and that is my concern.

>

>But the gyn " standard of care " for uterine fibroids is hysterectomy. And

>surely that IS covered by their insurance.

There are, in fact, a number of people with insurance who are being denied the

" gyn'standard of care' " for fibroids. I have a friend who has been denied a

hysterectomy for two years, and has just now gotten it approved. It is approved

now only because they suspect she may have cancer, rather than or in addition to

fibroids. When the question started popping up in conversations about why the

insurance companies wouldn't jump at paying for UFE, which is generally cheaper

than a hysterectomy, the response I got from my friend is that it is not cheaper

than doing nothing. In her personal experience, and that of others she has

encountered through her work as a nurse, women are increasingly being denied

hysterectomies as treatment for severely symptomatic fibroids. (My friend is

even severely anemic due to blood loss, so she isn't one for whom the watch and

wait approach is terribly appropriate.)

I agree with you that a voluntary act is, by definition, not coercive. I

suspect that our difference is how we define voluntary. In addition to women

who have the option of a hysterectomy but not UFE, there are women who are being

denied treatment altogether - some because they have insurance that will not

cover a hysterectomy, some because they have no insurance at all. A study which

gives them an option to be treated, on the condition that they accept a randomly

chosen treatment, when they would otherwise have no treatment option at all, is

not truly voluntary.

How coercive it seems to use randomization to fill the pool of participants for

the undesired option, is how attractive participation in the study is to women

with no real alternative choices. Does it pay for treatment, or do you have to

bring your own insurance, for example. I wish I had the article at my

fingertips - but there are large numbers of poverty stricken individuals whose

only means of obtaining medical treatment is via participation in drug and other

studies. Can you truly say those individuals are voluntarily participating in a

study, when, absent the study they would receive no treatment at all? A

randomized study between myo and UFE, where the randomization is to fill a

participant pool for the option which the vast majority of volunteers do not

want isn't truly voluntary if the study is designed in a way that the

participants are women who have no other options at all for treatment

(procedures paid for by study, personal insurance won't pay, no insurance, etc.)

I don't, of course, know the parameters of the study. If, for example, every

participant is required to have insurance that will cover either procedure then

participation is more likely to be truly voluntary than if the study pays for

the procedures and attracts large numbers of women who otherwise would not

receive treatment at all.

--

Reeves wrote:

>>The only reason I could see for randomization is if there were not

>>enough women interested in one or the other treatment option to gather

>>a comparison group. If that is the case, it does strike me as a bit

>>coercive - you can have the option of a UAE but only if you're willing

>>to risk undergoing a myo first (or vice versa)

>

>

>I was following you pretty good until I got to this " coercive "

>statement. How does a voluntary trial that people must pick up the phone

>and avail themselves personally of their own free will become " coercive " in

>your eyes? Certainly those same people could very well avail themselves of

>a specifically chosen procedure with the physician of their choice without

>ever entering a trial, could they not?

>

>But the gyn " standard of care " for uterine fibroids is hysterectomy. And

>surely that IS covered by their insurance.

>

>

Visit FindLaw at http://www.findlaw.com for free case law, web guide, and legal

news, and get your free @JusticeMail.com address at http://www.justicemail.com

[Guest guest]

Carla Dione wrote:

Certainly those same people could very well avail themselves of

>a specifically chosen procedure with the physician of their choice without

>ever entering a trial, could they not?

In a nutshell - no, and that is my concern.

>

>But the gyn " standard of care " for uterine fibroids is hysterectomy. And

>surely that IS covered by their insurance.

There are, in fact, a number of people with insurance who are being denied the

" gyn'standard of care' " for fibroids. I have a friend who has been denied a

hysterectomy for two years, and has just now gotten it approved. It is approved

now only because they suspect she may have cancer, rather than or in addition to

fibroids. When the question started popping up in conversations about why the

insurance companies wouldn't jump at paying for UFE, which is generally cheaper

than a hysterectomy, the response I got from my friend is that it is not cheaper

than doing nothing. In her personal experience, and that of others she has

encountered through her work as a nurse, women are increasingly being denied

hysterectomies as treatment for severely symptomatic fibroids. (My friend is

even severely anemic due to blood loss, so she isn't one for whom the watch and

wait approach is terribly appropriate.)

I agree with you that a voluntary act is, by definition, not coercive. I

suspect that our difference is how we define voluntary. In addition to women

who have the option of a hysterectomy but not UFE, there are women who are being

denied treatment altogether - some because they have insurance that will not

cover a hysterectomy, some because they have no insurance at all. A study which

gives them an option to be treated, on the condition that they accept a randomly

chosen treatment, when they would otherwise have no treatment option at all, is

not truly voluntary.

How coercive it seems to use randomization to fill the pool of participants for

the undesired option, is how attractive participation in the study is to women

with no real alternative choices. Does it pay for treatment, or do you have to

bring your own insurance, for example. I wish I had the article at my

fingertips - but there are large numbers of poverty stricken individuals whose

only means of obtaining medical treatment is via participation in drug and other

studies. Can you truly say those individuals are voluntarily participating in a

study, when, absent the study they would receive no treatment at all? A

randomized study between myo and UFE, where the randomization is to fill a

participant pool for the option which the vast majority of volunteers do not

want isn't truly voluntary if the study is designed in a way that the

participants are women who have no other options at all for treatment

(procedures paid for by study, personal insurance won't pay, no insurance, etc.)

I don't, of course, know the parameters of the study. If, for example, every

participant is required to have insurance that will cover either procedure then

participation is more likely to be truly voluntary than if the study pays for

the procedures and attracts large numbers of women who otherwise would not

receive treatment at all.

--

Reeves wrote:

>>The only reason I could see for randomization is if there were not

>>enough women interested in one or the other treatment option to gather

>>a comparison group. If that is the case, it does strike me as a bit

>>coercive - you can have the option of a UAE but only if you're willing

>>to risk undergoing a myo first (or vice versa)

>

>

>I was following you pretty good until I got to this " coercive "

>statement. How does a voluntary trial that people must pick up the phone

>and avail themselves personally of their own free will become " coercive " in

>your eyes? Certainly those same people could very well avail themselves of

>a specifically chosen procedure with the physician of their choice without

>ever entering a trial, could they not?

>

>But the gyn " standard of care " for uterine fibroids is hysterectomy. And

>surely that IS covered by their insurance.

>

>

Visit FindLaw at http://www.findlaw.com for free case law, web guide, and legal

news, and get your free @JusticeMail.com address at http://www.justicemail.com

[Guest guest]

Hi,

I have a question about the radomization in this study. Someone (I can't

remember who) asked why it had to be randomized and why the author couldn't

just study women who opt for one procedure or other.

Also from what I understand not all fibroids can be treated by UFE, so I'm

assuming those women would just be dropped from the study wouldn't that

cause some skewing of the results. It doesn't seem to me that these are

truly interchangeable treatments for fibroids.

I for one would not have gone for the randomization because I had UFE to

avoid surgery.

Heidi

[Guest guest]

Hi,

I have a question about the radomization in this study. Someone (I can't

remember who) asked why it had to be randomized and why the author couldn't

just study women who opt for one procedure or other.

Also from what I understand not all fibroids can be treated by UFE, so I'm

assuming those women would just be dropped from the study wouldn't that

cause some skewing of the results. It doesn't seem to me that these are

truly interchangeable treatments for fibroids.

I for one would not have gone for the randomization because I had UFE to

avoid surgery.

Heidi