Effectiveness criteria: rate of patients without failure or complication
In this cost-effectiveness analysis, the main criterion used to express the effectiveness of the initial menorrhagia surgery was the rate of patients without failure over time, for each surgical category. Using atime-to-event variable allowed considering both the proportion of failures that occurred in each surgical group and their time of occurrence. Failure (considered as the event) was defined as the first re-hospitalization that occurred either as i) stay for new bleeding surgery (Online supporting material 2 ), ii) stay containing a menorrhagia CIM-10 code stated as main- or related-diagnosis or iii) stay containing any CIM-10 codes for pregnancy .
As a secondary endpoint, effectiveness of the initial AUB surgery was also compared between strategies using the rate of patients without severe complications over time. Severe complication was defined as the first event that occurred either as 1) re-hospitalization during the 30 days following the surgery due to anemia, shock, any complication directly linked to the surgical intervention, pain, infection, blood supply, inflammatory disorders or hemoperitoneum within urologic, genital, abdominal or pelvic location or 2) re-hospitalization at any time after the initial surgery due to adhesions, foreign body, pain, ventral hernia, renal failure, intestinal obstruction or other digestive disorders, urologic/genital disorders within urologic, genital, abdominal or pelvic location.