Table 3.

Description of Inappropriateness Criteria for 1,256 RAND-Based and 479 Wright-Based Inappropriate Rated Noncancerous and Nonobstetric Hysterectomies in the Carolina Hysterectomy Cohort Received Between October 2, 2014, and December 31, 2017, Among Patients Aged 18–44 Years^a,b

Description	RAND classification	Wright classification
	N (%)	N (%)
Inappropriate Indication	150 (3.8)	141 (9.1)
Ovarian cyst or pelvic mass	141 (3.3)	141 (9.1)
Premenstrual syndrome/premenstrual dysphoric disorder	6 (0.1)	N.A.c
Low-grade cervical dysplasia	d	N.A.
Missing Diagnostic Procedures	1959 (46.1)	793 (51.2)
Procedures to assess potential causes of pain	634 (14.9)	N.A.
Procedures to assess potential causes of bleeding	1071 (25.2)	N.A
Procedures to assess pathology of cells	99 (2.3)	59 (3.8)
Pelvic examination	d	6 (0.4)
Imaging	200 (4.7)	728 (47.0)
Missing Medical Management	1294 (29.0)	461 (29.7) e
Hormone therapy, pain medication, or tranexamic acid	1033 (30.4)	461 (29.7)
Iron supplementation or blood transfusion	260 (6.1)	N.A
Missing adequate identification of a condition and/or level of severity	721 (17.0)	149 (9.6)
Diagnosis of a condition	68 (1.6)	58 (3.7)
Symptoms associated with the indication	63 (1.5)	91 (5.9)
Anemia or impairment due to diagnoses or symptoms	616 (14.5)	N.A
Missing operative procedure	95 (2.2)	d
Bilateral oophorectomy
Ineligible due to individual patient characteristics	34 (0.8)	2 (0.1)
Age	24 (0.5)	N.A
Family history	10 (0.2)	d
Total Criteria	4253 (100)	1549 (100)

^a Inappropriateness criteria are not mutually exclusive. Inappropriate rated hysterectomies could be missing multiple items.

^b Excluding indications not mentioned in RAND and primary indications for surgery that were never the lone indication.

^c Not Applicable for the Wright appropriateness algorithm.

^d Table cells with sample sizes <5 have been suppressed.

^e Missing medical management was criteria for an ambiguous rating in the Wright-based appropriateness algorithm.