Bayes Meets Markov – Oophorectomy and Age at Hysterectomy

BMI’s biostatistical consulting team supported the initial work that led to a May 2022 publication in the journal Obstetrics & Gynecology titled “A Revised Markov Model Evaluating Oophorectomy at the Time of Hysterectomy for Benign Indication.”

The investigators used updated Markov modeling to determine the best age for women undergoing hysterectomy for benign indications to also have bilateral salpingo-oophorectomy (BSO) without estrogen therapy.

The results support considering BSO at the time of hysterectomy for women aged 50 years and older, and initiating estrogen therapy for those under 50 who need BSO to mitigate any increased mortality risk from cardiovascular disease. These results are in contrast to the 2005 Markov model, which argued against BSO up to age 65 for patients undergoing hysterectomy for benign indications.