Re‐evaluating the eVALuate study and the NICE guidelines: a personal review

The eVALuate study, which compared outcomes after vaginal, abdominal and laparoscopic hysterectomy, was published in 2004 (Garry et al. BMJ 2004;328:129–33, Sculpher et al. BMJ 2004;328:134–9, Garry et al. Health Tech Assess 2004;8:1–154). It comprised two parallel studies involving a total of 1380 hysterectomies performed by 43 surgeons in 28 centres. It remains the largest randomised trial in the world literature in the field of hysterectomy and its contents have been given considerable weighting in the many subsequent meta-analyses including the NICE recommendations on ‘laparoscopic techniques for hysterectomy’ (nice.org.uk/guidance/ipg239ipg. 2004).