Evidence map›Paper›PMID 26698678›Full record

ArticleFertility and sterility2016

Following declining human chorionic gonadotropin values in pregnancies of unknown location: when is it safe to stop?

Katherine E Cameron, Suneeta Senapati, Mary D Sammel, Karine Chung, Peter Takacs, Thomas Molinaro, Kurt T Barnhart

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Fertility and sterility, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Katherine E CameronDepartment of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address: katherine.cameron@uphs.upenn.edu.
Suneeta SenapatiDepartment of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Mary D SammelDepartment of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Karine ChungDepartment of Obstetrics and Gynecology, University of Southern California, Los Angeles, California.
Peter TakacsDepartment of Obstetrics and Gynecology, University of Miami School of Medicine, Miami, Florida.
Thomas MolinaroDepartment of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Obstetrics and Gynecology, Rutgers-Robert Wood Johnson and Reproductive Medicine Associates of New Jersey, New Brunswick, New Jersey.
Kurt T BarnhartDepartment of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.

Funding

REPRODUCTIVE EPIDEMIOLOGY TRAINING GRANTT32HD007440 · NICHD · UNIVERSITY OF PENNSYLVANIA · PI BARNHART, KURT T · 1996 to 2020
$7.5M
WOMENS REPRODUCTIVE HEALTH RESEARCH CAREER DEVELOPMENTK12HD001265 · NICHD · UNIVERSITY OF PENNSYLVANIA · PI Elizabeth A Howell · 1998 to 2026
$7.5M
RISK FACTORS AS PREDICTORS OF ECTOPIC PREGNANCYR01HD036455 · NICHD · UNIVERSITY OF PENNSYLVANIA · PI BARNHART, KURT T · 1999 to 2010
$4.1M
Development of a serum biosignature for ectopic pregnancy.R01HD076279 · NICHD · UNIVERSITY OF PENNSYLVANIA · PI BARNHART, KURT T · 2014 to 2018
$3.4M
Midcareer investigator award in patient oriented researchK24HD060687 · NICHD · UNIVERSITY OF PENNSYLVANIA · PI BARNHART, KURT T · 2009 to 2014
$956k
NICHD NIH HHS K12 HD001265NICHD NIH HHS K24 HD060687NICHD NIH HHS R01 HD036455NICHD NIH HHS R01 HD076279NICHD NIH HHS T32 HD007440
6 · The paper itself

Abstract

objectiveTo determine if the pattern of decline in hCG curves can discriminate spontaneous abortion (SAB) from ectopic pregnancy (EP).

designRetrospective cohort study.

settingUniversity hospitals. PATIENT(S): A total of 1,551 women with symptomatic pregnancy of unknown location (PUL) and decreasing hCG values. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Percentage change in hCG; days and visits to final diagnosis. RESULT(S): Of the 1,551 women with a PUL and declining hCG, 146 were ultimately diagnosed with EP and 1,405 with SAB. An 85% hCG drop within 4 days or a 95% hCG drop within 7 days both ruled out an EP 100% of the time. Applying the 4-day cutoff to this population would have saved 16% of the SAB population (229/1,405) a total of 2,841 person-days and 277 clinical visits. Applying the 7-day cutoff would have saved 9% of the SAB population (126/1,405) a total of 1,294 person-days and 182 clinical visits. These cutoffs were separately validated on a group of 179 EPs collected from three university clinical centers. In that population, each cutoff separately ruled out EP 100% of the time. CONCLUSION(S): The decline in serum hCG is slower in EPs than in SAB and can be used to aid clinicians in the frequency and duration of follow-up. Costs and patient time may be saved by allowing women who meet one of these criteria to be followed less frequently.

Indexed as

Abortion, SpontaneousAdolescentAdultBiomarkersChildChorionic GonadotropinCohort StudiesFemaleFollow-Up StudiesHospitals, UniversityHumansMiddle AgedPregnancyPregnancy, EctopicRetrospective StudiesYoung AdultBiomarkersChorionic Gonadotropinectopic pregnancyhCG curvespregnancy of unknown location

Identifiers

PMID26698678
PMCPMC4821681

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.