Survey on Selected Gynecologic Conditions and Therapies

Online Survey Demo

PART A: CONDITIONS AND CURRENT TREATMENT OPTIONS

1. Approximately how many patients do you see WEEKLY for the following conditions, and for what share of those patients do you precribe drug therapy? Please specify the major drugs prescribed.

Condition	Patients Seen WEEKLY	Share Pre- scribed Drugs	Major Drug(s) Prescribed
	\| Numerical Values Only \|		Seperate the drugs with a comma (,)
Family Planning		%
Urinary Incontinence		%
Cancer Screening		%
Menopause		%
Menorrhagia		%
Pelvic Pain		%

2. How do you manage or treat the following conditions? Please indicate your first-line and second-line protocols for the MAJORITY of patients presenting with these conditions.

Condition	First-Line Therapy	Second-Line Therapy
	Seperate the drugs with a comma (,)	Seperate the drugs with a comma (,)
Family Planning
Stress Urinary Incontinence
Urge Incontinence
Suspected Cervical Cancer
Osteoporosis
Menopause Symptoms
Menorrhagia
Pelvic Pain

3. How would you rate the success of the treatment options you currently use for the specified conditions, and what share of your patients do you believe are refractory to these treatments.

Condition/Therapy	Success of Current Options							Approx Share of Patients Refract
	Inadequate				Excellent
	1	2	3	4	5	6
							\| Numerical Values Only \|
Family Planning								%
Stress Urinary Incontinence								%
Urge Incontinence								%
Suspected Cervical Cancer								%
Osteoporosis								%
Menopausal Symptoms								%
Menorrhagia								%
Pelvic Pain								%

PART B: FOCUS ON MENORRHAGIA

4. The selection of a menorrhagia treatment reflects many considerations, such as patient age, reproductive status, expected complications and procedure requirements. With these in mind, how would you rate the general attractiveness of the following menorrhagia treatment options considering the characteristics of the patients you are most likely to treat for this condition.

Not Desirable

Very Desirable

Hysterectomy

Dilation & Curettage

Hysteroscopic Ablation/Resection

Thermal Balloon Ablation

Microwave Ablation

RF Ablation

Cryoablation

Uterine Artery Embolization

Remarks:

5. What major concerns might you have regarding the various treatment options for menorrhagia? Please check the appropriate boxes only if you have a MAJOR concern.

Treatment Option	Invasiv- eness	Complica- tions	Effectiv- eness	Long-Term Outcome	Product Costs	Reimburse- ment
Hysterectomy
Dilation & Curettage
Hysteroscopic Ablation/Resection
Thermal Balloon Ablation
Microwave Ablation
RF Ablation
Cryoablation
Uterine Artery Embolization

6. Office-based ablation of menorrhagia offers several potential advantages over pharmacologic and surgical approaches. Please rate the following potential benefits on a scale of 1 to 6, with 6 = Significant Benefit and 1 = No Benefit.

No
Benefit

Significant Benefit

Minimally invasive treatment option

Does not contraindicate patient for subsequent therapy

May be used to stop periods

Provides economic benefit to practice

Other:

Remarks:

PART C: FOCUS ON OFFICE-BASED MODALITIES

7. In your opinion, what are the major advantages and limitations of the various screening and diagnostic options for cervical cancer? Please indicate the most important of these.

Treatment Option	Major Potential Advantages	Major Potential Limitations
Pap Test- Standard
Pap Test- Thin Prep
HPV Testing
Colposcopy
Endocervical Curettage
Reflective Spectroscopy
Optical Coherence Tomography

8. Are there specific gynecologic conditions for which you feel the following diagnostic and treatment approaches might be desirable? Please indicate the conditions about which you have strong feelings from either perspective.

	Conditions for Which I Believe the Approach Might Be:
	Particularly Promising	Strongly Contraindicated
Office-Based Laparoscopy
Office-Based Hysteroscopy
Office-Based Thermal Ablation
Office-Based Cryotherapy
Office-Based Ultrasound
Office-Based Culdoscopy

9. Assuming office-based approaches successfully diagnose or treat the following conditions with minimal complications, how many patients might you potentially treat MONTHLY using this protocol?

Condition	Potential Patients Treated MONTHLY	Remarks
	\| Numerical Values Only \|
Menorrhagia
Ovarian Cancer Pap Test
Incontinence
Infertility
Other:

THANK YOU for participating in this important research.
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