How women understand and use a tool to predict early pregnancy outcome: a qualitative analysis
File(s)
Published version
Author(s)
Lawson, Kim
Hall, Jennifer
Bourne, Tom
Bottomley, Cecilia
Type
Journal Article
Abstract
Objective
To explore how women, understand, interpret and use a validated individualised early pregnancy outcome prediction score tool.
Study Design
Qualitative interview study nested within a larger quantitative randomised controlled trial (RCT) within the Early Pregnancy Unit of a London teaching hospital. Women with an ultrasound diagnosis of an early intrauterine pregnancy of uncertain viability (PUV) were randomised to receive a validated outcome prediction score or routine care. Those who received the prediction were invited to interview. Thematic analysis was conducted with a focus on women’s experiences of receiving the prediction model. The study was complete when no further themes emerged.
Results
Eleven interviews were completed. Five themes emerged from the data: 1) Credibility, 2) Setting Expectations, 3) Sharing, 4) Reflecting and 5) Risks. Scientific development of the tool and delivery by a healthcare professional lent credibility. Women mostly found the prediction tool helpful in anticipating and preparing for the actual outcome. Women largely did not share their prediction outside immediate family. Where women perceived that the tool did not take sufficient account of individual previous experience, less value was attributed. Women also believed in a potential psychological risk from a high prediction of viability being followed by a poor outcome.
Conclusion
This study presents a nuanced understanding of women’s use of an outcome prediction tool, which is not found from standard quantitative data. Recognising how women rationalise and use information is as important as statistical performance of a tool when implementing supportive care interventions. Whilst the results give better understanding in cases of PUV, it is not known whether the findings can be generalised to other early pregnancy scenarios.
To explore how women, understand, interpret and use a validated individualised early pregnancy outcome prediction score tool.
Study Design
Qualitative interview study nested within a larger quantitative randomised controlled trial (RCT) within the Early Pregnancy Unit of a London teaching hospital. Women with an ultrasound diagnosis of an early intrauterine pregnancy of uncertain viability (PUV) were randomised to receive a validated outcome prediction score or routine care. Those who received the prediction were invited to interview. Thematic analysis was conducted with a focus on women’s experiences of receiving the prediction model. The study was complete when no further themes emerged.
Results
Eleven interviews were completed. Five themes emerged from the data: 1) Credibility, 2) Setting Expectations, 3) Sharing, 4) Reflecting and 5) Risks. Scientific development of the tool and delivery by a healthcare professional lent credibility. Women mostly found the prediction tool helpful in anticipating and preparing for the actual outcome. Women largely did not share their prediction outside immediate family. Where women perceived that the tool did not take sufficient account of individual previous experience, less value was attributed. Women also believed in a potential psychological risk from a high prediction of viability being followed by a poor outcome.
Conclusion
This study presents a nuanced understanding of women’s use of an outcome prediction tool, which is not found from standard quantitative data. Recognising how women rationalise and use information is as important as statistical performance of a tool when implementing supportive care interventions. Whilst the results give better understanding in cases of PUV, it is not known whether the findings can be generalised to other early pregnancy scenarios.
Date Issued
2025-04-01
Date Acceptance
2025-02-04
Citation
European Journal of Obstetrics Gynecology and Reproductive Biology, 2025, 307, pp.259-264
ISSN
0301-2115
Publisher
Elsevier
Start Page
259
End Page
264
Journal / Book Title
European Journal of Obstetrics Gynecology and Reproductive Biology
Volume
307
Copyright Statement
© 2025 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by nc-nd/4.0/).
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/39999727
PII: S0301-2115(25)00065-X
Subjects
Fetal viability
Miscarriage
Qualitative research
Uncertainty
Publication Status
Published
Coverage Spatial
Ireland
Date Publish Online
2025-02-05