{"id":"https://openalex.org/W7225344611","doi":"https://doi.org/10.52054/fvvo.2026.454","title":"The CLARK ratio: a novel metric for the conduct of outpatient hysteroscopy","display_name":"The CLARK ratio: a novel metric for the conduct of outpatient hysteroscopy","publication_year":2026,"publication_date":"2026-11-05","ids":{"openalex":"https://openalex.org/W7225344611","doi":"https://doi.org/10.52054/fvvo.2026.454","pmid":"https://pubmed.ncbi.nlm.nih.gov/42985905"},"language":"en","primary_location":{"id":"doi:10.52054/fvvo.2026.454","doi":"https://doi.org/10.52054/fvvo.2026.454","is_oa":true,"landing_page_url":"https://doi.org/10.52054/fvvo.2026.454","pdf_url":"https://fvvo.eu/pdf/58770459-5a06-4076-a747-5b73e24cd7c0/articles/FVVO.2026.454/1-2026.454.pdf","source":{"id":"https://openalex.org/S4210226648","display_name":"Facts Views and Vision in ObGyn","issn_l":"2032-0418","issn":["2032-0418","2684-4230"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","ddh","doaj","dongbi-d","doyens","norway-1","poland-40","russia-white-list-2","vabb-shw"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Facts Views and Vision in ObGyn","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"diamond","oa_url":"https://fvvo.eu/pdf/58770459-5a06-4076-a747-5b73e24cd7c0/articles/FVVO.2026.454/1-2026.454.pdf","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5043103874","display_name":"T. Justin Clark","orcid":"https://orcid.org/0000-0002-5943-1062","observed_orcids":["https://orcid.org/0000-0002-5943-1062"]},"institutions":[{"id":"https://openalex.org/I4210099987","display_name":"Birmingham Women's Hospital","ror":"https://ror.org/00xe5zs60","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I4210099987","https://openalex.org/I4210155225"]},{"id":"https://openalex.org/I4210155225","display_name":"Birmingham Women\u2019s and Children\u2019s NHS Foundation Trust","ror":"https://ror.org/056ajev02","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I4210155225"]}],"countries":["GB"],"is_corresponding":true,"raw_author_name":"T. Justin Clark","raw_affiliation_strings":["Department of Obstetrics and Gynaecology, Birmingham Women's Hospital, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, United Kingdom"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Obstetrics and Gynaecology, Birmingham Women's Hospital, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, United Kingdom","institution_ids":["https://openalex.org/I4210099987","https://openalex.org/I4210155225"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5043103874"],"corresponding_institution_ids":["https://openalex.org/I4210099987","https://openalex.org/I4210155225"],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11589","display_name":"Gynecological conditions and treatments","score":0.9452999830245972,"subfield":{"id":"https://openalex.org/subfields/2729","display_name":"Obstetrics and Gynecology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11589","display_name":"Gynecological conditions and treatments","score":0.9452999830245972,"subfield":{"id":"https://openalex.org/subfields/2729","display_name":"Obstetrics and Gynecology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10600","display_name":"Reproductive Health and Contraception","score":0.016300000250339508,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12443","display_name":"Delphi Technique in Research","score":0.004000000189989805,"subfield":{"id":"https://openalex.org/subfields/3312","display_name":"Sociology and Political Science"},"field":{"id":"https://openalex.org/fields/33","display_name":"Social Sciences"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/outpatient-hysteroscopy","display_name":"outpatient hysteroscopy","score":0.8889999985694885},{"id":"https://openalex.org/keywords/patient-acceptability","display_name":"patient acceptability","score":0.9079999923706055},{"id":"https://openalex.org/keywords/procedural-failure","display_name":"procedural failure","score":0.9490000009536743},{"id":"https://openalex.org/keywords/quality-of-care-benchmarking","display_name":"quality of care benchmarking","score":0.5540000200271606},{"id":"https://openalex.org/keywords/quality-assurance","display_name":"quality assurance","score":0.7149999737739563},{"id":"https://openalex.org/keywords/patient-experience","display_name":"patient experience","score":0.7519999742507935},{"id":"https://openalex.org/keywords/real-world-evidence","display_name":"real-world evidence","score":0.8360000252723694},{"id":"https://openalex.org/keywords/outcome-measures","display_name":"outcome measures","score":0.6830000281333923}],"concepts":[{"id":"https://openalex.org/C176217482","wikidata":"https://www.wikidata.org/wiki/Q860554","display_name":"Metric (unit)","level":2,"score":0.7925999760627747},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.6642000079154968},{"id":"https://openalex.org/C148220186","wikidata":"https://www.wikidata.org/wiki/Q7111912","display_name":"Outcome (game theory)","level":2,"score":0.6438999772071838},{"id":"https://openalex.org/C185798385","wikidata":"https://www.wikidata.org/wiki/Q1161707","display_name":"Benchmark (surveying)","level":2,"score":0.5065000057220459},{"id":"https://openalex.org/C2775963564","wikidata":"https://www.wikidata.org/wiki/Q597058","display_name":"Hysteroscopy","level":2,"score":0.44780001044273376},{"id":"https://openalex.org/C2779530757","wikidata":"https://www.wikidata.org/wiki/Q1207505","display_name":"Quality (philosophy)","level":2,"score":0.423799991607666},{"id":"https://openalex.org/C19527891","wikidata":"https://www.wikidata.org/wiki/Q1120908","display_name":"Medical physics","level":1,"score":0.4041999876499176},{"id":"https://openalex.org/C106436119","wikidata":"https://www.wikidata.org/wiki/Q836575","display_name":"Quality assurance","level":3,"score":0.36070001125335693},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.3483999967575073},{"id":"https://openalex.org/C3020110884","wikidata":"https://www.wikidata.org/wiki/Q695416","display_name":"Outpatient clinic","level":2,"score":0.3440000116825104},{"id":"https://openalex.org/C2777896191","wikidata":"https://www.wikidata.org/wiki/Q22907655","display_name":"Patient experience","level":3,"score":0.3398999869823456},{"id":"https://openalex.org/C71405471","wikidata":"https://www.wikidata.org/wiki/Q757012","display_name":"Quality management","level":3,"score":0.3379000127315521},{"id":"https://openalex.org/C545542383","wikidata":"https://www.wikidata.org/wiki/Q2751242","display_name":"Medical emergency","level":1,"score":0.32839998602867126},{"id":"https://openalex.org/C2775944032","wikidata":"https://www.wikidata.org/wiki/Q22907659","display_name":"Patient satisfaction","level":2,"score":0.3278000056743622},{"id":"https://openalex.org/C3018822202","wikidata":"https://www.wikidata.org/wiki/Q1324077","display_name":"Patient data","level":2,"score":0.32659998536109924},{"id":"https://openalex.org/C168563851","wikidata":"https://www.wikidata.org/wiki/Q1436668","display_name":"Randomized controlled trial","level":2,"score":0.31949999928474426},{"id":"https://openalex.org/C2780898871","wikidata":"https://www.wikidata.org/wiki/Q860554","display_name":"Performance metric","level":2,"score":0.30889999866485596},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.2838999927043915},{"id":"https://openalex.org/C2779328685","wikidata":"https://www.wikidata.org/wiki/Q1475557","display_name":"Patient safety","level":3,"score":0.2678999900817871},{"id":"https://openalex.org/C2779951463","wikidata":"https://www.wikidata.org/wiki/Q7268788","display_name":"Quality of life (healthcare)","level":2,"score":0.25589999556541443},{"id":"https://openalex.org/C2779343474","wikidata":"https://www.wikidata.org/wiki/Q3109175","display_name":"Context (archaeology)","level":2,"score":0.2556000053882599},{"id":"https://openalex.org/C535046627","wikidata":"https://www.wikidata.org/wiki/Q30612","display_name":"Clinical trial","level":2,"score":0.2522999942302704},{"id":"https://openalex.org/C124306116","wikidata":"https://www.wikidata.org/wiki/Q2512965","display_name":"Ambulatory care","level":3,"score":0.2500999867916107}],"mesh":[],"locations_count":2,"locations":[{"id":"doi:10.52054/fvvo.2026.454","doi":"https://doi.org/10.52054/fvvo.2026.454","is_oa":true,"landing_page_url":"https://doi.org/10.52054/fvvo.2026.454","pdf_url":"https://fvvo.eu/pdf/58770459-5a06-4076-a747-5b73e24cd7c0/articles/FVVO.2026.454/1-2026.454.pdf","source":{"id":"https://openalex.org/S4210226648","display_name":"Facts Views and Vision in ObGyn","issn_l":"2032-0418","issn":["2032-0418","2684-4230"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","ddh","doaj","dongbi-d","doyens","norway-1","poland-40","russia-white-list-2","vabb-shw"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Facts Views and Vision in ObGyn","raw_type":"journal-article"},{"id":"pmid:42985905","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42985905","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Facts, views & vision in ObGyn","raw_type":"Journal Article"}],"best_oa_location":{"id":"doi:10.52054/fvvo.2026.454","doi":"https://doi.org/10.52054/fvvo.2026.454","is_oa":true,"landing_page_url":"https://doi.org/10.52054/fvvo.2026.454","pdf_url":"https://fvvo.eu/pdf/58770459-5a06-4076-a747-5b73e24cd7c0/articles/FVVO.2026.454/1-2026.454.pdf","source":{"id":"https://openalex.org/S4210226648","display_name":"Facts Views and Vision in ObGyn","issn_l":"2032-0418","issn":["2032-0418","2684-4230"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","ddh","doaj","dongbi-d","doyens","norway-1","poland-40","russia-white-list-2","vabb-shw"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Facts Views and Vision in ObGyn","raw_type":"journal-article"},"sustainable_development_goals":[{"score":0.9391000270843506,"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7225344611.pdf","grobid_xml":"https://content.openalex.org/works/W7225344611.grobid-xml"},"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W2552702975","https://openalex.org/W2105176655","https://openalex.org/W3140162178","https://openalex.org/W4210622764","https://openalex.org/W4416065049","https://openalex.org/W3122002440","https://openalex.org/W4393947763","https://openalex.org/W2043496382","https://openalex.org/W2418799270","https://openalex.org/W2001655467"],"abstract_inverted_index":{"There":[0],"is":[1,28,73,78],"a":[2,79,95],"balance":[3],"between":[4],"procedural":[5,39],"success":[6],"and":[7,58,63,70,82,92,104],"patient":[8,35,71],"acceptability":[9,36],"in":[10,106],"outpatient":[11,109],"hysteroscopy.":[12],"Reporting":[13],"either":[14],"outcome":[15,65,105],"alone":[16],"inadequately":[17],"reflects":[18],"how":[19],"well":[20],"the":[21,30],"procedure":[22],"was":[23],"conducted.":[24],"A":[25],"new":[26,80],"metric":[27],"proposed:":[29],"\"Clark":[31],"ratio\",":[32],"defined":[33],"as":[34,94],"divided":[37],"by":[38],"failure,":[40],"to":[41,67,89],"capture":[42],"this":[43],"trade-off.":[44],"Higher":[45],"ratios":[46],"indicate":[47],"better":[48],"performance.":[49],"The":[50,75],"limitations":[51],"of":[52],"data":[53],"from":[54],"randomised":[55],"controlled":[56],"trials":[57],"need":[59],"for":[60,101,108],"real-world":[61],"evidence":[62],"standardised":[64],"measures":[66],"validate":[68],"feasibility":[69],"experience":[72],"discussed.":[74],"Clark":[76],"ratio":[77],"concept":[81],"could":[83],"potentially":[84],"be":[85,90],"adopted,":[86],"if":[87],"found":[88],"valid":[91],"useful,":[93],"simple,":[96],"easily":[97],"interpretable,":[98],"pragmatic":[99],"benchmark":[100],"quality":[102],"assurance":[103],"research":[107],"hysteroscopic":[110],"procedures.":[111]},"counts_by_year":[],"updated_date":"2026-11-08T12:12:28.789561","created_date":"2026-11-06T00:00:00"}