Study protocol: quantitative fibronectin to help decision-making in women with symptoms of preterm labour (QUIDS) part 2, UK Prospective Cohort Study

• Published in: BMJ open Vol. 8; no. 4; p. e020795
• Main Authors: Stock, Sarah Jane, Wotherspoon, Lisa M, Boyd, Kathleen Anne, Morris, Rachel K, Dorling, Jon, Jackson, Lesley, Chandiramani, Manju, David, Anna L, Khalil, Asma, Shennan, Andrew, Hodgetts Morton, Victoria, Lavender, Tina, Khan, Khalid, Harper-Clarke, Susan, Mol, Ben, Riley, Richard D, Norrie, John, Norman, Jane
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.04.2018; BMJ Publishing Group
• Subjects: Adolescent; Adult; Anxiety; Cervix; Cervix Uteri; Clinical decision making; Cohort analysis; Cost analysis; Decision making; Decision Support Techniques; Female; Fibronectins; Health services; Humans; Infant, Newborn; Information services; Medical diagnosis; Models, Theoretical; Mortality; Obstetric Labor, Premature - diagnosis; Obstetric Labor, Premature - therapy; Obstetrics and Gynaecology; Pharmacoeconomics; Predictive Value of Tests; Pregnancy; Premature Birth; Prognosis; Prospective Studies; Systematic review; United Kingdom; Womens health; Young Adult; United Kingdom; United Kingdom > UK; Scotland; fetal fibronectin; preterm birth; cervix; diagnostic test; pregnancy
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2017-020795

IntroductionThe aim of the QUIDS study is to develop a decision support tool for the management of women with symptoms and signs of preterm labour, based on a validated prognostic model using quantitative fetal fibronectin (fFN) concentration, in combination with clinical risk factors.Methods and analysisThe study will evaluate the Rapid fFN 10Q System (Hologic, Marlborough, Massachusetts, USA) which quantifies fFN in a vaginal swab. In QUIDS part 2, we will perform a prospective cohort study in at least eight UK consultant-led maternity units, in women with symptoms of preterm labour at 22+0 to 34+6 weeks gestation to externally validate a prognostic model developed in QUIDS part 1. The effects of quantitative fFN on anxiety will be assessed, and acceptability of the test and prognostic model will be evaluated in a subgroup of women and clinicians (n=30). The sample size is 1600 women (with estimated 96–192 events of preterm delivery within 7 days of testing). Clinicians will be informed of the qualitative fFN result (positive/negative) but be blinded to quantitative fFN result. Research midwives will collect outcome data from the maternal and neonatal clinical records. The final validated prognostic model will be presented as a mobile or web-based application.Ethics and disseminationThe study is funded by the National Institute of Healthcare Research Health Technology Assessment (HTA 14/32/01). It has been approved by the West of Scotland Research Ethics Committee (16/WS/0068).VersionProtocol V.2, Date 1 November 2016.Trial registration number ISRCTN 41598423andCPMS: 31277.