• About Us
    • Contact Us
    • Login
    • ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
About Us Contact Us Login ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
Grand Rounds

A Score for Predicting ObGyn Conditions in the Emergency Department

image_pdfFavoriteLoadingFavorite

BACKGROUND AND PURPOSE:

  • Okada et al. (American Journal of Emergency Medicine, 2021) performed an external validation of the POP score to predict presence of ObGyn disorder in the ED

METHODS:

  • Multi-center, retrospective cohort study (2017 to 2020)
    • 3 hospitals | None involved in the initial development of the POP score
  • Population
    • Young adult women aged 16 to 49 years with abdominal pain in the ED
  • POP score
    • Screening tool to assess the likelihood of underlying obstetrics and gynecological diseases
    • The POP score is comprised of three predictors, each worth one point
      • Past history of ObGyn diseases: +1 if present
      • Other Symptoms (fever or digestive symptoms): +1 if not present
      • Peritoneal irritations signs: +1 if present
    • In a previous study, if POP score was 3 points (the max), the risk of OBGYN disease was 55%; if the score was 0, the risk was 1 to 2%
  • Study design
    • The POP score was used to calculate the probability of Obgyn diseases, using logistic regression
    • Predictions were compared with observations to evaluate the calibration of the mode
  • Primary outcome
    • Screening performance characteristics of the POP score
      • Sensitivity | Specificity | Likelihood ratio

RESULTS:

  • 1026 women
    • Median (IQR) age: 31 (23 to 41) years
  • Discrimination performance of the POP score (AUC): 0.645 (95% CI, 0.603 to 0.687)
  • The predicted probabilities of OBGYN diseases using the POP score was generally well-calibrated to the observations
  • When the cut-off was set between 2 and 3 points for the ruling in of OBGYN diseases
    • Sensitivity: 0.064 (95% CI, 0.026 to 0.127)
    • Specificity: 0.993 (95% CI, 0.986 to 0.998)
    • Positive likelihood ratio: 9.72 (95% CI, 3.33 to 28.4)
    • Utility of POP score to rule in ObGyn condition
  • When the cut-off was set between 0 and 1 points for ruling out of OBGYN diseases
    • Sensitivity: 0.973 (95% CI, 0.922 to 0.994)
    • Specificity: 0.151 (95% CI, 0.128 to 0.175)
    • Negative likelihood ratio: 0.181 (95% CI, 0.059 to 0.558)
    • Utility of POP score to rule out ObGyn condition
  • Non-ObGyn diagnoses
    • Most patients who did not receive an ObGyn diagnosis had GI disease (e.g., infectious enteritis)

CONCLUSION:

  • The POP score to predict ObGyn disorders was externally validated for use in the emergency department for women presenting with abdominal pain
  • A POP score of 2 to 3

…would encourage vaginal examinations and pelvic or transvaginal ultrasonography for making the definitive diagnosis of OBGYN disease in an early phase, resulting in an efficient clinical process

  • A Pop Score of 1 to 2 would direct evaluation toward GI or GU pathology and consideration given to

… additional tests (e.g., blood test, transabdominal ultrasonography, and computed tomography)

Learn More – Primary Sources:

External validation of the POP score for predicting obstetric and gynecological diseases in the emergency department

Want to stay on top of key guidelines and research papers?

ObGFirst® – Try It Free! »

image_pdfFavoriteLoadingFavorite
< Previous
All Grand Rounds Posts
Next >

Related ObG Topics:

Can Point-of-Care Ultrasound by Emergency Physicians Reduce Pregnant Women’s Stay in the Emergency Room?
Results from the PROPER Trial: What are the Pulmonary Embolism Rule-Out Criteria (PERC) and Do They Really Work?
Where Does all the Money Go? Estimated Administrative Costs Related to Physician Billing Activities

Sections

  • COVID-19
  • Alerts
  • OB
  • GYN
    • GYN
    • Sexual Health
  • 2T US Atlas
  • The Genome
  • Primary Care
  • Your Practice
  • Grand Rounds
  • My Bookshelf
  • Now@ObG
  • Media

Are you an
ObG Insider?

Get specially curated clinical summaries delivered to your inbox every week for free

  • Site Map/
  • © ObG Project/
  • Terms and Conditions/
  • Privacy/
  • Contact Us/
© ObG Project
SSL Certificate


  • Already an ObGFirst Member?
    Welcome back

    Log In

    Want to sign up?
    Get guideline notifications
    CME Included

    Sign Up

Get Guideline Alerts Direct to Your Phone
Try ObGFirst Free!

Sign In

Lost your password?

Sign Up for ObGFirst and Stay Ahead

  • - Professional guideline notifications
  • - Daily summary of a clinically relevant
    research paper
  • - Includes 1 hour of CME every month

ObGFirst Free Trial

Already a Member of ObGFirst®?

Please log in to ObGFirst to access the 2T US Atlas

Password Trouble?

Not an ObGFirst® Member Yet?

  • - Access 2T US Atlas
  • - Guideline notifications
  • - Daily research paper summaries
  • - And lots more!
ObGFirst Free Trial

Media - Internet

Computer System Requirements

OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Jointly provided by

NOT ENOUGH CME HOURS

It appears you don't have enough CME Hours to take this Post-Test. Feel free to buy additional CME hours or upgrade your current CME subscription plan

Subscribe

JOIN OBGFIRST AND GET CME/CE CREDITS

One of the benefits of an ObGFirst subscription is the ability to earn CME/CE credits from the ObG entries you read. Tap the button to learn more about ObGFirst

Learn More
Leaving ObG Website

You are now leaving the ObG website and on your way to PRIORITY at UCSF, an independent website. Therefore, we are not responsible for the content or availability of this site