QUiPP app helps clinicians better identify women at risk of preterm birth
by Lauren Dubinsky, Senior Reporter | January 20, 2016
Health IT
Risk Management
Women's Health
The saying, "There's an app for that," seems to be making its way into health care. Researchers at King's College London have developed an app called QUiPP that helps clinicians better identify women who are at risk of giving birth prematurely.
A preterm birth is when an infant is born before 37 weeks of pregnancy. In 2014, about one in every 10 infants were born prematurely in the U.S., according to the Centers for Disease Control and Prevention.
"The current app incorporates the best predictors of preterm birth i.e aspects of the history of previous pregnancies, quantifiable fetal fibronectin, and cervical length," Andrew Shennan, lead author of a study investigating the app and professor of obstetrics at King's College London, wrote to HCB News in an e-mail. "Together they are far more accurate than any alone, but more importantly they give a precise risk [assessment] calculated for the doctor, rather than relying on the doctor's experience or knowledge."
Many different factors are considered to determine if a woman is at risk of giving birth prematurely, including a history of preterm births or late miscarriages, the length of cervix and levels of a biomarker found in vaginal fluid known as fetal fibronectin, which is usually tested at 23 weeks.
The researchers have further developed the fetal fibronectin test so that it can be used to accurately assess risk during the first half of pregnancy. The app uses an algorithm that combines the gestation of previous pregnancies and the length of the cervix with levels of fetal fibronectin to assess a woman's risk.
The researchers conducted two studies that tested the app — the first study focused on women who were considered high risk mostly because of a previous early pregnancy, despite not showing any symptoms, and the second study focused on the chances of premature birth in women who had symptoms of early labor.
For the first study, the researchers gathered data from 1,249 women at high risk who attended preterm surveillance clinics. The estimated chance of delivery before 30, 34, or 37 weeks' gestations, and within two or four weeks of testing for fetal fibronectin, was calculated for each of the patients and then evaluated as a predictive test for the actual occurrence of each event.
For the second study, the researchers collected data from 382 high-risk women, and a model was developed on the first 190 women and confirmed on the other 192. In both studies, the app was shown to perform well as a predictive tool and was much more accurate than when each of the risk factors are used alone to predict risk.
"Our research has shown the app to be very reliable," wrote Shennan. "Having calculated the best method from a large group of women, when tried out on other women it remains very accurate."
Even though the app has demonstrated successful results in the two studies, more research is needed to investigate its use in clinical practice and to determine whether the intervention improves pregnancy outcomes for women who the app considers high risk.
The app can be downloaded for free in the Apple store. Shennan wrote that all of the clinicians who use the app are very enthusiastic about it.
"It has proved very popular in Australia, with hundreds of downloads, where preterm births in remote communities are very challenging, and transfers expensive," he added.
A preterm birth is when an infant is born before 37 weeks of pregnancy. In 2014, about one in every 10 infants were born prematurely in the U.S., according to the Centers for Disease Control and Prevention.
"The current app incorporates the best predictors of preterm birth i.e aspects of the history of previous pregnancies, quantifiable fetal fibronectin, and cervical length," Andrew Shennan, lead author of a study investigating the app and professor of obstetrics at King's College London, wrote to HCB News in an e-mail. "Together they are far more accurate than any alone, but more importantly they give a precise risk [assessment] calculated for the doctor, rather than relying on the doctor's experience or knowledge."
Many different factors are considered to determine if a woman is at risk of giving birth prematurely, including a history of preterm births or late miscarriages, the length of cervix and levels of a biomarker found in vaginal fluid known as fetal fibronectin, which is usually tested at 23 weeks.
The researchers have further developed the fetal fibronectin test so that it can be used to accurately assess risk during the first half of pregnancy. The app uses an algorithm that combines the gestation of previous pregnancies and the length of the cervix with levels of fetal fibronectin to assess a woman's risk.
The researchers conducted two studies that tested the app — the first study focused on women who were considered high risk mostly because of a previous early pregnancy, despite not showing any symptoms, and the second study focused on the chances of premature birth in women who had symptoms of early labor.
For the first study, the researchers gathered data from 1,249 women at high risk who attended preterm surveillance clinics. The estimated chance of delivery before 30, 34, or 37 weeks' gestations, and within two or four weeks of testing for fetal fibronectin, was calculated for each of the patients and then evaluated as a predictive test for the actual occurrence of each event.
For the second study, the researchers collected data from 382 high-risk women, and a model was developed on the first 190 women and confirmed on the other 192. In both studies, the app was shown to perform well as a predictive tool and was much more accurate than when each of the risk factors are used alone to predict risk.
"Our research has shown the app to be very reliable," wrote Shennan. "Having calculated the best method from a large group of women, when tried out on other women it remains very accurate."
Even though the app has demonstrated successful results in the two studies, more research is needed to investigate its use in clinical practice and to determine whether the intervention improves pregnancy outcomes for women who the app considers high risk.
The app can be downloaded for free in the Apple store. Shennan wrote that all of the clinicians who use the app are very enthusiastic about it.
"It has proved very popular in Australia, with hundreds of downloads, where preterm births in remote communities are very challenging, and transfers expensive," he added.
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