VP42.04: The feasibility of implementation of pre‐eclampsia screening and prevention
Bibliographic record
Abstract
acceptability (PE screening uptake, aspirin initiation); operational impact (additional time taken); impact of performance audit of biochemical and biophysical markers. Prospective feasibility study. Consecutive pregnant women referred for FTS (11-13+6 weeks) consenting to PE screening based on maternal risk factors, mean arterial pressure (MAP), uterine artery Doppler pulsatility index (UTAD PI), pregnancy-associated plasma protein-A (PAPP-A) and placental growth factor (PLGF)). Risk for preterm PE (< 37 weeks) calculated using FMF UK algorithm. Women identified at high-risk (≧1/100) advised to initiate aspirin under supervision of their primary healthcare provider (162 mg OD @hs from < 16 to 36 weeks). All operators FMF UK certified, regular performance audit. Between Dec 1, 2020-April 23, 2021, 1123 pregnant women consented to PE screening (98.3% uptake), 8.2% screen positive rate. The expected number of cases of preterm PE overall was 5.8 (0.5%), of these, 4.1 (69%) screened positive for preterm PE (< 37 weeks). Appointments for women receiving FTS aneuploidy and PE screening took on average 10 minutes longer than for those receiving FTS alone, adding UTAD PI averaged 2 minutes. Performance audit identified MAP to be 10% lower than expected (adjustment factor has since been applied); other variables satisfactory. Of screen positives contacted at 14-15 week's gestation (n = 70), 87% had initiated aspirin, 12.8% did not; 22 have not yet responded. This study demonstrates the feasibility of implementing an evidence-based PE screening and prevention program. The importance of regular performance audit of biochemical and biophysical variables is demonstrated. This data will facilitate implementation as a clinical service. Impacts on local obstetrical and health services outcomes will be examined.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.018 | 0.043 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
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 source (direct Gemma or distilled Codex), 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".