Evidence map›Paper›PMID 37144747›Full record

ArticleThe Australian & New Zealand journal of obstetrics & gynaecology2023

Validation of a tool for determining the clinical utility of stillbirth investigations.

Tania Marsden, T Yee Khong, Jane E Dahlstrom, David Ellwood, Ali Moghimi, Stacey Prystupa, Cecilia O'brien, Fathima Cassam, Skye Martin, Michael Coory and 2 more

Open access · hybridAbstract read
In one paragraph

Article in The Australian & New Zealand journal of obstetrics & gynaecology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.2field-weighted citation impact, top 44% 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

2 citing papers in PubMed, 1 citations in OpenAlex.

  1. Clinical Utility of Stillbirth Investigations in Australia: A Cohort Study.The Australian & New Zealand journal of obstetrics & gynaecology · 2026
    Article
  2. 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

12 authors at 9 institutions in 1 country.

Tania MarsdenNHMRC Centre of Research Excellence in Stillbirth, Mater Research Institute - University of Queensland, Brisbane, Queensland, Australia.ORCID 0000-0003-1270-1122
T Yee KhongSA Pathology, Women's and Children's Hospital, Adelaide, South Australia, Australia.
Jane E DahlstromACT Pathology, Canberra Health Services and Australian National University Medical School, Canberra, Australian Capital Territory, Australia.
David EllwoodNHMRC Centre of Research Excellence in Stillbirth, Mater Research Institute - University of Queensland, Brisbane, Queensland, Australia.ORCID 0000-0003-4512-6443
Ali MoghimiThe Children's Hospital at Westmead, Sydney, New South Wales, Australia.
Stacey PrystupaEastern Health, Sydney, Victoria, Australia.
Cecilia O'brienTownsville University Hospital, Townsville, Queensland, Australia.
Fathima CassamMater Mothers Hospital, Brisbane, Queensland, Australia.
Skye MartinTownsville University Hospital, Townsville, Queensland, Australia.
Michael CooryFaculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia.
Frances M BoyleNHMRC Centre of Research Excellence in Stillbirth, Mater Research Institute - University of Queensland, Brisbane, Queensland, Australia.
Vicki FlenadyNHMRC Centre of Research Excellence in Stillbirth, Mater Research Institute - University of Queensland, Brisbane, Queensland, Australia.ORCID 0000-0001-8114-7677
The University of Queensland · AUTownsville Hospital · AUAustralian National University · AUChildren's Hospital at Westmead · AUEastern Health · AUGriffith University · AUMater Mothers' Hospital · AUSouth Australia Pathology · AUThe University of Melbourne · AU

Funding

NHMRC 1029613Stillbirth Centre for Research Excellence
6 · The paper itself

Abstract

backgroundUp to 20% of all stillbirths and 45% of term stillbirths are currently classified as unexplained. Many of these stillbirths do not undergo currently recommended investigations. This may leave questions unanswered and not identify stillbirths with a recurrence risk in subsequent pregnancies.

aimsTo validate a new tool (Stillbirth Investigation Utility Tool) to identify the clinical utility of investigations in stillbirth and the inter-rater agreement on cause of stillbirth using the Perinatal Society of Australia and New Zealand-Perinatal Death Classification (PSANZ-PDC). MATERIALS AND

methodsThirty-four stillbirths were randomly selected for inclusion, each assessed independently by five blinded assessors. The investigations were grouped into three categories: clinical and laboratory; placental pathology; and autopsy examination. The cause of death was assigned at the end of each group. Outcome measures were clinical utility of investigations measured by assessor rated usefulness and inter-rater agreement on the assigned cause of death.

resultsComprehensive maternal history, maternal full blood count, maternal blood group and screen and placenta histopathology were useful in all cases. Clinical photographs were not performed and should have been performed in 50% of cases. The inter-rater agreement on cause of death assigned after all investigation results was 0.93 (95% CI 0.87-1.0).

conclusionsThe new Stillbirth Investigation Utility Tool showed very good agreement in assigning the cause of death using PSANZ-PDC. Four investigations were useful in all cases. Minor refinements will be made based on feedback to enhance usability for wider implementation in research studies to assess the yield of investigations in stillbirths.

Indexed as

Placenta DiseasesPregnancy ComplicationsCause of DeathFemaleHumansPlacentaPregnancyStillbirthautopsyclinical utilitydeath classificationinvestigationsplacentastillbirthyield

Identifiers

PMID37144747
PMCPMC10952271
OpenAlexW4372334159

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.