TY  - JOUR
A1  - Klein, Evelyn
A1  - Schlembach, Dietmar
A1  - Ramoni, Angela
A1  - Langer, Elena
A1  - Bahlmann, Franz
A1  - Grill, Sabine
A1  - Schaffenrath, Helene
A1  - Does, Reinhard van der
A1  - Messinger, Diethelm
A1  - Verhagen-Kamerbeek, Wilma D. J.
A1  - Reim, Manfred
A1  - Hund, Martin
A1  - Stepan, Holger
T1  - Influence of the sFlt-1/PlGF ratio on clinical decision-making in women with suspected preeclampsia
T2  - PLoS one
N2  - Objective: To evaluate the influence of the soluble fms-like tyrosine kinase 1/placental growth factor ratio in physicians’ decision making in pregnant women with signs and symptoms of preeclampsia in routine clinical practice.
Methods: A multicenter, prospective, open, non-interventional study enrolled pregnant women presenting with preeclampsia signs and symptoms in several European perinatal care centers. Before the soluble fms-like tyrosine kinase 1/placental growth factor ratio result was known, physicians documented intended clinical procedures using an iPad® application (data locked/time stamped). After the result was available, clinical decisions were confirmed or revised and documented. An independent adjudication committee evaluated the appropriateness of decisions based on maternal/fetal outcomes. Clinician decision making with regard to hospitalization was the primary outcome.
Results: In 16.9% of mothers (20/118) the hospitalization decision was changed after knowledge of the ratio. In 13 women (11.0%), the initial decision to hospitalize was changed to no hospitalization. In seven women (5.9%) the revised decision was hospitalization. All revised decisions were considered appropriate by the panel of adjudicators (McNemar test; p < 0.0001).
Conclusions: The use of the soluble fms-like tyrosine kinase 1/placental growth factor test influenced clinical decision making towards appropriate hospitalization in a considerable proportion of women with suspected preeclampsia. This is the first study to demonstrate the impact of angiogenic biomarkers on decision making in a routine clinical practice.
KW  - Preeclampsia
KW  - Pregnancy
KW  - Placental growth factor
KW  - Tyrosine kinases
KW  - Decision making
KW  - Hospitals
KW  - Eclampsia
KW  - Physicians
Y1  - 2016
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/45779
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-457790
SN  - 1932-6203
N1  - Copyright: © 2016 Klein et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
VL  - 11
IS  - (5): e0156013
SP  - 1
EP  - 19
PB  - PLoS
CY  - Lawrence, Kan.
ER  -