Cambian al inglÚs (Reino Unido)   

QMUL
Accuracy of clinical characteristics, biochemical and ultrasound markers in the
prediction of preeclampsia: an Individual Patient Data (IPD) Meta-analysis

 

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Summary:

Despite advances in maternal medicine, pre-eclampsia continues to be a major contributor to maternal, fetal and neonatal mortality and morbidity. Pre-eclampsia is not a single disorder but a syndrome. The early onset disease is more severe, and is considered to have a different pathophysiology than the late onset disease. It is unlikely that one single model will accurately predict both early and late onset disease. A HTA brief called for synthesis of available evidence to identify the most accurate tests, separately and in combination for the prediction of pre-eclampsia, including the early onset type. We have identified over 50 published evidence synthesis projects on this topic, and they are unable to provide clear conclusions on the performance of the tests due to the limitations in the published data.
We will obtain the individual data of all participants in relevant studies, through our International Prediction of Pre-eclampsia IPD Collaborative (IPPIC) Network. The Network comprises of researchers involved in studies on this topic and we have the support of more than 70 researchers, with access to data from over 400,000 women. The IPPIC Network is strengthened by support from the Global Obstetrics Research Network (GONet), a group of international investigators that perform clinical trials and observational studies in maternal fetal medicine and obstetrics (www.globalobstetricsnetwork.org). All collaborators will be involved in providing input into the project and will be co-authors in any publication arising from the project.

 

Aims and objetives:

We will develop separate prediction models for a. early (<34 weeks’ gestation) and b. any pre-eclampsia.
Primary

1.To update our systematic review on prediction models for pre-eclampsia and externally validate the most accurate and robust models on IPD.

2.To estimate the prognostic value of individual clinical, biochemical and ultrasound markers in the prediction of pre-eclampsia analysis

3. To use IPD from multiple studies to develop and externally validate (using internal-external cross-validation) multivariable prediction models for

 a. early (<34 weeks’ gestation) and  b. any pre-eclampsia based on (i) clinical characteristics only, and in combination with (ii) biochemical markers,
         (iii) ultrasound markers (iv) both ultrasound and biochemical markers

4.To assess the differential performance of the predictors in subgroups based on population characteristics (unselected vs selected), timing of test
(first trimester vs any trimester) in predicting pre-eclampsia, and treatment strategies  

Secondary

5.To evaluate the predictive accuracy of the individual tests and models for maternal and fetal complications of pre-eclampsia  


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