Abstract
Objective To develop a new method for estimating the effectiveness of emergency contraception (EC) by using information about previous menstrual cycle length, accounting for the variation in the day of ovulation within the menstrual cycle, and comparing the validity of the new and previous methods.
METHOD(S): Secondary analysis of a data set with a biological marker of ovulation and its distribution in the cycle. Based on a sample of cycles with known length and a known biological marker of ovulation, we simulated trials of predetermined EC effectiveness and then calculated estimates of EC effectiveness based on old and new methods.
RESULT(S): Under some conditions, all methods produced biased estimates of effectiveness with simulated trials, especially when the actual effectiveness was low. The systematic bias was minimized with the new method. The new method was robust with regard to the distribution of the day of intercourse in women presenting for EC.
CONCLUSION(S): Future studies of EC effectiveness should consider both the uncertainty in predicting the day of ovulation and previous cycle length. Our estimates of daily fecundity should be replicated with other data sets.
emergency contraception effectiveness estimation methods, Stanford JB ovulation timing research, menstrual cycle length variation ovulation prediction, Mikolajczyk Stanford EC bias correction, daily fecundity probability intercourse timing, biological marker ovulation day estimation, simulated trials contraception effectiveness methodology, cycle length adjustment emergency contraception studies, fertility awareness ovulation day uncertainty, secondary analysis EC effectiveness bias
PMID 15950649 15950649 DOI 10.1016/j.fertnstert.2005.01.097 10.1016/j.fertnstert.2005.01.097
Keywords
Contraception, Postcoital/methods/statistics & Numerical Data, Databases, Factual/statistics & Numerical Data, Female, Humans, Menstrual Cycle, Ovulation, Time Factors