Introduction
Methods
Protocol and registration
Literature search
Authors (year) | Country | Sample (N) | Prospective | Recruit patients | Detection of progesterone | Cut-off ng/mL | Supplement | Data extraction | Outcome assessment (weeks) | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Location | Age (years) | Gestation (weeks) | Tp | Fp | Fn | Tn | Time | Method | ||||||||
Kadam [21] (2019) | India | 150 | Yes | Outpatient | UK | < 12 | Enzyme | 11 | UK | 41 | 17 | 4 | 88 | < 13 | Ultrasound | |
Kant [20] (2015) | India | 100 | Yes | Outpatient | 20–39 | < 12 | Enzyme | 24 | UK | 16 | 3 | 5 | 76 | 20 | Follow up | |
Ku [26] (2015) | Singapore | 119 | Yes | Emergency | > 19 | 6–10 | CL | 11 | UK | 23 | 11 | 7 | 78 | < 17 | Follow up | |
LeK [24] (2017) | Singapore | 345 | Yes | Emergency | > 21 | 6–10 | CL | 11 | UK | 46 | 22 | 24 | 253 | 16 | Follow up | |
Jia [23] (2018) | Singapore | 118 | Yes | Emergency | 21–45 | 6–10 | CL | 11 | Yes | 10 | 8 | 5 | 95 | < 16 | Follow up | |
Tan [25] (2020) | Singapore | 1087 | Yes | Emergency | UK | 5–12 | CL | 11 | Yes | 170 | 70 | 81 | 766 | 16 | Follow up | |
Duan [16] (2011) | China | 175 | No | Outpatient | UK | 4–5 | Enzyme | 16 | Yes | 51 | 32 | 16 | 76 | Live birth | Follow up | |
Wei [18] (2022) | China | 141 | UK | Hospitalized | 22–43 | 5–12 | CL | 22 | Yes | 16 | 10 | 10 | 105 | 16 | Follow up | |
Zheng [19] (2021) | China | 173 | UK | Outpatient | > 20 | 5–6 | CL | 10 | Yes | 38 | 21 | 14 | 100 | 12 | Follow up | |
Li [17] (2019) | China | 100 | No | Outpatient | 22–35 | 5–7 | UK | 10 | Yes | 18 | 10 | 8 | 64 | 12 | Follow up | |
Shen [15] (2013) | China | 76 | UK | Outpatient | UK | < 12 | CL | 30 | Yes | 38 | 7 | 6 | 25 | Live birth | Follow up | |
McLindon [22] (2023) | Australia | 133 | Yes | Outpatient | > 18 | < 10 | UK | 8 | Yes | 8 | 2 | 15 | 108 | Live birth | Follow up | |
128 | No | 4 | 1 | 17 | 106 | |||||||||||
133 | 16 | Yes | 17 | 42 | 6 | 68 | ||||||||||
128 | No | 14 | 41 | 7 | 66 |
Study selection
Data extraction and quality assessment
Outcomes assessment
Statistical analysis
Results
Characteristics of included studies
Quality assessment
Study | Risk of bias | Applicability Concerns | |||||
---|---|---|---|---|---|---|---|
Patient Selection | Index Test | Reference Standard | Flow and Timing | Patient Selection | Index Test | Reference Standard | |
Duan et al. [16] | U | U | U | L | L | L | H |
Jia et al. [23] | L | L | L | U | L | L | L |
Kadam et al. [21] | L | U | L | L | L | L | L |
Kant et al. [20] | L | U | L | L | L | L | L |
Ku et al. [26] | L | L | L | L | L | L | L |
LeK et al. [24] | L | L | L | U | L | L | L |
Li et al. [17] | U | L | L | L | L | L | L |
McLindon et al. [22] | L | L | U | U | L | L | H |
Shen et al. [15] | H | L | U | L | U | L | H |
Tan et al. [25] | L | L | L | L | L | L | L |
Wei et al. [18] | U | U | L | L | L | L | L |
Zheng et al. [19] | U | U | L | L | L | L | L |
Diagnostic performance
Subgroup analysis
Dataset(n) | ROC | Sensitivity | Specificity | Positive likelihood ratio | Negative likelihood ratio | Diagnostic odds ratio | Threshold effect (P value) | Heterogeneity (I2) | |
---|---|---|---|---|---|---|---|---|---|
All combined | 15 | 0.85(0.81–0.88) | 0.69(0.60–0.77) | 0.89(0.81–0.94) | 6.2(4.0-9.7) | 0.35(0.27–0.43) | 18(12–27) | 0.85 | 98% |
Subgroup analysis | |||||||||
Threshold value(ng/mL) | |||||||||
<12 | 9 | 0.90(0.87–0.92) | 0.65(0.49–0.77) | 0.92(0.87–0.95) | 8.3(5.9–11.7) | 0.38(0.27–0.55) | 22(16–29) | 1.00 | 96% |
12–30 | 6 | 0.78(0.74–0.81) | 0.75(0.68–0.81) | 0.80(0.65–0.90) | 3.8(2.0-7.1) | 0.31(0.24–0.41) | 12(5–27) | 0.45 | 86% |
Recruit patients | |||||||||
Outpatient | 10 | 085(0.81–0.88) | 0.69(0.55–0.81) | 0.88(0.75–0.94) | 5.6(2.9–10.6) | 0.35(0.24–0.51) | 16(9–30) | 0.66 | 98% |
Hospitalized or Emergency | 5 | 0.89(0.86–0.92) | 0.68(0.63–0.72) | 0.91(0.90–0.93) | 7.9(6.6–9.5) | 0.35(0.31–0.41) | 22(17–30) | 0.70 | 100% |
Measurement method | |||||||||
Enzyme* | 3 | 0.90 | 0.81(0.74–0.88) | 0.82(0.77–0.86) | 5.7(2.3–13.9) | 0.23(0.12–0.44) | 29(6-145) | 0.67 | NA |
Chemiluminescence | 7 | 0.88(0.85–0.90) | 0.72(0.65–0.78) | 0.89(0.86–0.92) | 6.7(5.1–8.6) | 0.32(0.26–0.39) | 21(16–28) | 1.00 | 67% |
Progesterone supplement | |||||||||
Yes | 9 | 0.83(0.79–0.86) | 0.71(0.62–0.78) | 0.87(0.78–0.93) | 5.5(3.3-9.0) | 0.34(0.28–0.41) | 16(11–25) | 1.00 | 97% |
No or unclear | 6 | 0.88(0.85–0.91) | 0.69(0.48–0.84) | 0.91(0.78–0.97) | 7.9(3.4–18.2) | 0.34(0.20–0.60) | 23(10–55) | 0.53 | 96% |
Out of China | |||||||||
No | 10 | 0.86(0.82–0.89) | 0.66(0.52–0.78) | 0.91(0.82–0.96) | 7.6(4.0-14.4) | 0.37(0.26–0.52) | 21(11–37) | 0.69 | 98% |
Yes | 5 | 0.84(0.80–0.87) | 0.74(0.65–0.81) | 0.82(0.74–0.89) | 4.2(2.9–6.1) | 0.32(0.24–0.41) | 13(8–21) | 1.00 | 76% |
Follow up (weeks) | |||||||||
≤20 | 9 | 0.89(0.86–0.92) | 0.72(0.66–0.78) | 0.90(0.87–0.92) | 7.1(5.8–8.6) | 0.31(0.25–0.38) | 23(18–30) | 1.00 | 76% |
>20 | 6 | 0.80(0.76–0.83) | 0.63(0.40–0.81) | 0.87(0.61–0.96) | 4.7(1.8–12.0) | 0.43(0.28–0.66) | 11(5–23) | 0.96 | 98% |