Evidence map›Paper›PMID 35921048›Full record

SynthesisCJEM2022

Performance of single serum progesterone in the evaluation of symptomatic first-trimester pregnant patients: a systematic review and meta-analysis.

Bahareh Ghaedi, Wei Cheng, Sara Ameri, Khadeer Abdulkarim, Nicholas Costain, Ayesha Zia, Venkatesh Thiruganasambandamoorthy

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in CJEM, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.2field-weighted citation impact, top 22% of its field
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

3 citing papers in PubMed, 6 citations in OpenAlex.

  1. Review
  2. Article
  3. Progesterone: The Key Factor of the Beginning of Life.International journal of molecular sciences · 2022
    Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 3 countries.

Bahareh Ghaedi *Department of Clinical Epidemiology Program-Emergency Medicine, Clinical Epidemiology Unit, Ottawa Hospital Research Institute, ON, Ottawa, Canada.
Wei Cheng *Yale School of Public Health, New Haven, USA.
Sara AmeriDepartment of Clinical Epidemiology Program-Emergency Medicine, Clinical Epidemiology Unit, Ottawa Hospital Research Institute, ON, Ottawa, Canada.
Khadeer AbdulkarimRoyal College of Surgeons in Ireland, Dublin, Ireland.
Nicholas CostainDepartment of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada.
Ayesha ZiaDepartment of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada.
Venkatesh ThiruganasambandamoorthyDepartment of Clinical Epidemiology Program-Emergency Medicine, Clinical Epidemiology Unit, Ottawa Hospital Research Institute, ON, Ottawa, Canada. vthirug@ohri.ca.ORCID 0000-0003-4373-3688
University of Ottawa · CAOttawa Hospital · CARoyal College of Surgeons in Ireland · IE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesPain and bleeding complicate 30% of pregnancies, raising concerns for viability. The objective is to evaluate the diagnostic characteristics of a single serum progesterone level in assessing pregnancy viability among symptomatic patients.

methodsWe conducted a predefined literature search in MEDLINE, Embase (OVID), CINAHL and Cochrane databases for studies that enrolled patients in first trimester with miscarriage symptoms, measured progesterone and reported pregnancy viability, from inception to July 2020. We extracted data for 2 × 2 tables, progesterone threshold levels and viability. We obtained summary estimates of sensitivity, specificity, Diagnostic Odds Ratio (DOR), and predictive values at given prevalence rates.

resultsWe identified 54 publications. There was a total of 15,878 patients enrolled, of whom 7864 patients (49.5%) were confirmed to have a viable pregnancy and 8014 patients (50.5%) were confirmed to have a non-viable pregnancy. The cut-off value of progesterone ranged from 3.2 to 25 ng/mL (20.034-79.5 nmol/L). We evaluated the performance of the following progesterone cut-off categories: < 6.3, 6.3-12.6, 12.7-19.9, and 20-25 ng/mL. To detect non-viable pregnancy, progesterone with cut-off < 6.3 ng/mL had sensitivity 73.1%, specificity 99.2% and DOR 322.0 (PPV 0.91, 0.97 and 0.99 at prevalences 0.1, 0.25, 0.5, respectively, indicating higher likelihood of non-viable pregnancy), and cut-off category 20-25 ng/mL had sensitivity 91.3%, specificity 75% and DOR 31.4 (NPV 0.99, 0.96 and 0.89 at the prevalences above indicating higher likelihood of viable pregnancy).

conclusionA single progesterone level provides a clinically useful prognostic information on pregnancy viability. More than nine out of ten patients with a level < 6.3 ng/mL (< 20.034 nmol/L) will be diagnosed with a non-viable pregnancy, and more than 90% of patients with a level ≥ 20-25 ng/mL (63.6-79.5 nmol/L) will have a viable pregnancy confirmed.

Indexed as

Abortion, SpontaneousProgesteroneFemaleHumansPredictive Value of TestsPregnancyPregnancy Trimester, FirstSensitivity and SpecificityProgesteroneEctopic pregnancyMiscarriagePregnancy viabilityProgesteroneSensitivitySpecificity

Identifiers

PMID35921048
OpenAlexW4289544552

What OpenQuestion holds

Textmetadata
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.