External validation in cohort of 2,916 women undergoing digital cervical examination at 22–24 weeks.
Prospective validation of the Bishop Score (and comparison with the the digital Cervical Score) as a predictor of spontaneous preterm delivery before 35 weeks of gestation. Data from a cohort of 2,916 singleton pregnancies enrolled in a multicenter preterm prediction study were available. Patients underwent digital cervical examinations at 22–24 for calculation of Bishop Score and Cervical Score. Relationships between Bishop Score, Cervical Score, and spontaneous preterm delivery were assessed with multivariable logistic regression analysis, McNemar’s test, and receiver operating characteristics (ROC) curves to identify appropriate diagnostic thresholds and predictive capability.

RESULTS
One hundred twenty-seven of 2,916 patients (4.4%) undergoing cervical examination at 22–24 weeks had a spontaneous preterm delivery before 35 weeks. ROC curves indicated that optimal diagnostic thresholds for Bishop Score were at least 4 at 22–24 weeks. At 22–24 weeks’ gestation, the area under the ROC curve was significantly larger for the Bishop Score than for the Cervical Score (0.66 versus 0.61, p=0.03), indicating that overall, Bishop Score is a better diagnostic test at this gestation. However, McNemar’s test revealed that a Cervical Score < 1.5 was superior to a Bishop Score ≥ 4 (p<0.001) for the prediction of SPTD < 35 weeks’ gestation. For 86.6% of the patients, the timing of delivery was correctly predicted by both tests and for 4.4% of the patients both tests were wrong. For 7.4% of the patients the Cervical Score was correct while the Bishop Score was wrong, and for 1.6% of the patients the Bishop Score was correct while the Cervical Score was wrong.

CONCLUSIONS
Both cervical evaluations are associated with spontaneous preterm delivery in a singleton population, however, predictive capabilities for spontaneous preterm delivery were modest among women with low event prevalence. Overall, the Bishop Score performed better in the mid-trimester compared to the Cervical Score as a predictor of spontaneous preterm delivery before 35 weeks.
Research authors: Newman RB, Goldenberg RL, Lams JD, Meis PJ, Mercer BM, Moawad AH, Thom E, Miodovnik E, Caritis SN, Dombrowski M, and Thurnau GR.
Details
Download

Discrimination

Rows included 0
C-index 0.66 ROC
Brier score Not specified
Scaled Brier score Not specified

Classification plot

Not specified

Calibration

Regression coefficient 0
Intercept 0
Hosmer-Lemeshow GOF Not specified
 

Calibration plot

Not specified

Histogram

Not specified

Decision curve

Not specified
Comparison
Original study population: 500
Validation study population: 2916
Comments
Comment
Please enter a comment
Comments are visible to anyone

Model feedback

No feedback yet 1 Comment {{ comments.length }} Comments
On {{ comment.created_at }} {{ comment.user.username }} a no longer registered author wrote:
{{ comment.content }}
Evidencio v3.25 © 2015 - 2024 Evidencio. All Rights Reserved