SynthesisPloS one2024
Development and validation of a risk assessment model for predicting the failure of early medical abortions: A clinical prediction model study based on a systematic review and meta-analysis.
Synthesis in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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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.
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Who cites it
2 citing papers in PubMed.
- Abortion-A brief description of the evolution of methods.Acta obstetricia et gynecologica Scandinavica · 2026Article
- Ultrasound-derived gestational sac triple product as a predictor of early medical abortion failure with mifepristone-misoprostol regimens: a retrospective cohort study.Frontiers in medicine · 2026Article
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Authors and funding
15 authors.
Funding
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Abstract
objectiveAs the first model in predicting the failure of early medical abortion (EMA) was inefficient, this study aims to develop and validate a risk assessment model for predicting the failure of EMAs more accurately in a clinical setting.
methodsThe derivation cohort was obtained from a comprehensive systematic review and meta-analysis. The clinically significant risk factors were identified and combined with their corresponding odds ratios to establish a risk assessment model. The risk factors were assigned scores based on their respective weightings. The model's performance was evaluated by an external validation cohort obtained from a tertiary hospital. The outcome was defined as the incidence of EMA failure.
resultsA total of 126,420 patients who had undergone medical abortions were included in the systematic review and meta-analysis, and the pooled failure rate was 6.7%. The final risk factors consisted of gestational age, maternal age, parity, previous termination of pregnancy, marital status, type of residence, and differences between gestational age calculated using the last menstrual period and that measured via ultrasound. The risk factors were assigned scores based on their respective weightings, with a maximum score of 19. The clinical prediction model exhibited a good discrimination, as validated by external verification (402 patients) with an area under the curve of 0.857 (95% confidence interval 0.804-0.910). The optimal cutoff value was determined to be 13.5 points, yielding a sensitivity of 83.3% and specificity of 75.4%.
conclusionThis study effectively establishes a simple risk assessment model including seven routinely available clinical parameters for predicting EMA failure. In preliminary validation, this model demonstrates good performance in terms of predictive efficiency, accuracy, calibration, and clinical benefit. However, more research and validation are warranted for future application. TRIAL REGISTRATION NUMBER: CRD42023485388.
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