Ectopic Pregnancy Clinical Trial
Official title:
Risk Factors as Predictors of Ectopic PRegnancy
The purpose of this study is to identify elements of a patient's demographics, history, and clinical presentation that may aid in differentiating between patients with an ectopic pregnancy, miscarriage, or normal intrauterine pregnancy. This study will also evaluate serial levels of human chorionic gonadotropin in the serum of these patients, as another way to make the diagnosis.
The backbone of this protocol is the systematic evaluation of the presentation, work up,
diagnosis and treatment outcome of women who present for evaluation of pain or bleeding in
the first trimester of pregnancy and are therefore at risk for ectopic pregnancy (EP). Our
focus is women whose diagnosis was not definitive upon initial presentation. We plan to
collect systematic data regarding the current diagnostic strategies and treatment of these
women and compare actual outcomes to those predicted by our newly developed strategies. This
will be the first time such an endeavor has been conducted at multiple centers
concomitantly. Expansion to two other sites is vital to ensure our preliminary data is valid
and generalizable to women from different races and ethnicities, as well as to achieve the
precision necessary to develop an accurate clinical tool. We will use a secure web-based
clinical database (the Quantbook) to compile clinical information, and will download
de-identified data to the research database once the diagnosis and clinical course of a
patient has been completed. The Quantbook will be an expansion of a clinical database
successfully utilized at Penn for the past 15 years. For a more detailed description of the
Quantbook and research databases please see Attachment 2 of the full protocol. High quality
information obtained from this cohort of women will allow the optimization and validation of
our currently derived and proposed methods of diagnosis.
Data Collection Clinical Database (Quantbook): The clinician (e.g., attending physician,
fellow, resident physician, nurse practitioner) who assesses the patient input information
into the Quantbook. At the first presentation, this will include the patient's medical
history, as well as presenting signs and symptoms. Results of tests ordered, including hCG
and relevant chemistry, hematology, blood type, and ultrasound, will be entered. The
clinician will assign a clinical impression (which may be a final definitive diagnosis, or a
suspected diagnosis, or "unable to determine"). Follow-up contacts and assessments are
recorded as they occur. Each time the patient returns for an assessment, the clinical
impression can be updated, until a definitive diagnosis is made. A research coordinator will
be tasked to monitor the Quantbook to provide quality control that the clinical data entered
is complete and correct.
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Observational Model: Cohort, Time Perspective: Prospective
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