Sir,
We would like to thank Sharma and colleagues for their interest in our
recent study evaluating the effectiveness and safety of surgical
interventions for Bartholin’s cyst or abscess.1
Their response highlights the unique opportunity offered by randomised
trials, and their syntheses into meta‐analyses, to assess patient
reported outcomes. We would strongly encourage researchers to select,
collect and report patient reported outcomes in future research
evaluating interventions for Bartholin’s cyst or
abscess.2
The primary outcome should be the outcome of greatest therapeutic
importance to the study’s prospective hypothesis. There is currently no
consensus regarding the selection of outcomes and methods of definition
or measurement for randomized trials evaluating interventions for
Bartholin’s cyst or abscess.3 In the absence of a
standardized approach, researchers have made arbitrary decisions when
choosing among several important outcomes.4 It would
be useful for healthcare professionals, researchers, and women with
lived experience of Bartholin’s cyst or abscess to engage in a formal
consensus development process to agree appropriate primary and secondary
outcomes.3
We agree the use of adjuvant antibiotics is an important consideration.
They were not reported by any of the included trials.5
We have no experience of marsupialization performed under local
anaesthetic. In our opinion, this approach would need to be evaluated
within a research setting. The recent COVID-19 pandemic would provide
additional impetus to undertake this much needed research.
James M. N. Duffy 1,2, Emma Kirk 3,
BJG Illingworth 4, K Stocking 5,
Marian Showell 6
1 Institute for Women’s Health, University College
London, London, United Kingdom.
2 King’s Fertility, Fetal Medicine Research
Foundation, London, United Kingdom.
3 Department of Obstetrics and Gynaecology, Royal Free
London NHS Trust, London, United Kingdom.
4 North West Anglia NHS Foundation Trust, Peterborough
City Hospital, Peterborough, UK
5 Centre for Biostatistics, Division of Population
Health, Health Services Research and Primary Care, University of
Manchester, Manchester, UK
6 Cochrane Gynaecology and Fertility Group, University
of Auckland, Auckland, New Zealand.