Recommendations from international clinical guidelines for routine antenatal infection screening
Bibliographic record
Abstract
AIM: Maternal infections in pregnancy may cause severe child morbidity. In this article, we aim to summarise recommendations from international evidence-based clinical guidelines for infection screening in pregnancy. METHODS: We conducted a systematic search for evidence-based guidelines in two databases (Guidelines International Network and National Guideline Clearinghouse) and a hand search on websites of international institutions and societies that develop evidence-based guidelines. We considered guidelines published from the 1 of January 2007 onwards and developed in Western, industrialised countries. The guidelines in our analysis had to be based on a systematic literature search in at least two databases and needed to provide recommendations explicitly linked to the evidence. We included five general antenatal clinical practice guidelines from Australia, UK and the United States and 20 disease-specific guidelines published by Canadian, German, UK and US guideline development groups. RESULTS: The comparison of evidence-based guidelines from nine different guideline development groups for 17 antenatal infection screenings showed variations in directions (pro-screening or contra-screening) as well as in grades of recommendations. Uniformly, all-pro-universal or all-contra-universal screening recommendations were identified for 10 of 17 diseases. Contradictions were primarily observed for group B streptococcus, chlamydia trachomatis, genital herpes and gonorrhoea infection screening. Whereas certainty of recommendations was high for all-pro-screening recommendations, it decreased in all-contra-screening recommendations and even displayed conflicting results for contradictory recommendations. CONCLUSION: The variety of grades of recommendations hamper across-guideline comparison. Nevertheless, the article highlights agreed screening areas based on the best available evidence as well as areas of still existing uncertainty. Local health policy decisions on whether to include or refrain from including screening measures in preventive care programmes can be facilitated by the comparison of recommendations from international evidence-based guidelines. Beyond the availability of evidence each country's health policy makers will have to make a judgement on the value of the test for a population-wide screening.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.023 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".