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Machine Learning Miscarriage Management Clinical Decision Support Tool Study

Recruiting
Conditions
Miscarriage in First Trimester
Interventions
Other: Expectant Management of First Trimester Miscarriage
Other: Medical Management of First Trimester Miscarriage
Registration Number
NCT06384144
Lead Sponsor
Imperial College London
Brief Summary

Machine learning used to develop an algorithm to determine chance of success with expectant or medical management for an individual patient. Taking into account the following objective measures:

* Demographics: Maternal Age, Parity

* History: Previous CS, Previous SMM/MVA, Previous Myomectomy

* Gestation by LMP

* Presenting symptoms: Bleeding score, Pain score

* USS Measurements: CRL, GS, RPOC 3 dimensions, Vascularity

* Discrepancy between gestation by CRL and LMP

Audit to collate 1000 cases and identify features contributing to an algorithm that can predict outcome of miscarriage management for individualized case management.

Detailed Description

* Artificial intelligence discovery science: Algorithm Development based on a retrospective Audit of approximately 1000 cases of miscarriage

* To determine the reliability of the tool with test data sets

* To increase the sensitivity and specificity of the decision aid by widening the data collection to multiple sites and testing the algorithm with prospective data

The study will be conducted at Queen Charlotte's and Chelsea Hospital at Imperial College Healthcare NHS Trusts (Primary Centre of the study).

This is a multi-centre retrospective, cohort observational study.

The study will be conducted over a minimum of three years to enable sufficient time to go through the retrospective data and collate test data sets.

Retrospective annonymised cases of missed miscarriage and incomplete miscarriage managed at Imperial College Healthcare NHS Trust will be analyse:

For each case the following clinical features will be collated and outcomes:

* Demographics: Maternal Age, Parity

* History: Previous CS, Previous SMM/MVA, Previous Myomectomy

* Gestation by LMP

* Presenting symptoms: Bleeding score, Pain score

* USS Measurements: CRL, GS, RPOC 3 dimensions, Vascularity

* Discrepancy between gestation by CRL and LMP

All data will be collected retrospectively and annonymised.

Following data collection, machine learning models and feature reduction methods will be applied to determine the best performing model to predict success or failure of expectant or medical management of miscarriage respectively.

The next phase will include a prospective audit to collect data and test the predictive power of the MLM clinical decision support tool.

Recruitment & Eligibility

Status
RECRUITING
Sex
Female
Target Recruitment
1000
Inclusion Criteria
  • Missed miscarriage and incomplete miscarriage less than 14weeks gestation
  • Follow-up recorded at 2 weeks
Exclusion Criteria
  • Final outcome data unavailable

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Expectant Management of MiscarriageExpectant Management of First Trimester MiscarriageCohort that chose to pursue expectant management of miscarriage, final outcome success or failure by day 14 from management choice
Medical Management of MiscarriageMedical Management of First Trimester MiscarriageCohort that chose to pursue medical management of miscarriage, final outcome success or failure by day 14 from management choice
Primary Outcome Measures
NameTimeMethod
Machine learning predictive model development for miscarriage management outcomes.Jan 2023- June 2024

Machine learning predictive model development based on a retrospective audit of approximately 1000 cases of miscarriage.

Secondary Outcome Measures
NameTimeMethod
Prospective audit to test and validate predictive modelJuly 2024-June 2025

To increase the sensitivity and specificity of the decision aid by widening the data collection to multiple sites and testing the machine learning model with prospective data.

Trial Locations

Locations (1)

Imperial College Heatlhcare NHS Trust

🇬🇧

London, United Kingdom

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