The CLARK ratio: a novel metric for the conduct of outpatient hysteroscopy

There is a balance between procedural success and patient acceptability in outpatient hysteroscopy. Reporting either outcome alone inadequately reflects how well the procedure was conducted. A new metric is proposed: the "Clark ratio", defined as patient acceptability divided by procedural failure, to capture this trade-off. Higher ratios indicate better performance. The limitations of data from randomised controlled trials and need for real-world evidence and standardised outcome measures to validate feasibility and patient experience is discussed. The Clark ratio is a new concept and could potentially be adopted, if found to be valid and useful, as a simple, easily interpretable, pragmatic benchmark for quality assurance and outcome in research for outpatient hysteroscopic procedures.