Quantitative fibronectin to help decision-making in women with symptoms of preterm labour (QUIDS) part 1: individual participant data meta-analysis and health economic analysis

Stock, Sarah J., Wotherspoon, Lisa M., Boyd, Kathleen A., Morris, Rachel K., Dorling, Jon, Jackson, Lesley, Chandiramani, Manju, David, Anna L., Khalil, Asma, Shennan, Andrew, Hodgetts Morton, Victoria, Lavender, Tina, Khan, Khalid, Harper-Clarke, Susan, Mol, Ben W., Riley, Richard D., Norrie, John and Norman, Jane E. (2018) Quantitative fibronectin to help decision-making in women with symptoms of preterm labour (QUIDS) part 1: individual participant data meta-analysis and health economic analysis. BMJ Open, 8 (4), [e020796]. (doi:10.1136/bmjopen-2017-020796).

Abstract

Introduction The aim of the QUIDS study is to develop a decision support tool for the management of women with symptoms and signs of preterm labour, based on a validated prognostic model using quantitative fetal fibronectin (qfFN) concentration, in combination with clinical risk factors. Methods and analysis The study will evaluate the Rapid fFN 10Q System (Hologic, Marlborough, Massachusetts) which quantifies fFN in a vaginal swab. In part 1 of the study, we will develop and internally validate a prognostic model using an individual participant data (IPD) meta-analysis of existing studies containing women with symptoms of preterm labour alongside fFN measurements and pregnancy outcome. An economic analysis will be undertaken to assess potential cost-effectiveness of the qfFN prognostic model. The primary endpoint will be the ability of the prognostic model to rule out spontaneous preterm birth within 7 days. Six eligible studies were identified by systematic review of the literature and five agreed to provide their IPD (n=5 studies, 1783 women and 139 events of preterm delivery within 7 days of testing). Ethics and dissemination The study is funded by the National Institute of Healthcare Research Health Technology Assessment (HTA 14/32/01). It has been approved by the West of Scotland Research Ethics Committee (16/WS/0068).

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Contributors

Author: Jon Dorling

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