A CLAHRC NWL grant is funding a multi-centre intervention to implement a diagnostic support tool (DST) into everyday clinical practice for the purpose of establishing a standardized, evidence-based, care model to diagnose ectopic pregnancy. The motivation for this project comes from the difficulty associated with diagnosing a pregnancy of unknown location (PUL), or an ectopic pregnancy- defined as a woman with a positive pregnancy test wherein the pregnancy cannot be visualized either inside or outside the uterus on an internal vaginal ultrasound scan.

Some ectopic pregnancies can be dangerous and potentially life-threatening, especially if left untreated. As of yet, there is no standard model for diagnosing this precarious condition, necessitating a coalition of relevant bodies to implement the use of a well-researched theoretical DST into clinical practice. The two step triage protocol that has been developed as a result can select PUL at high risk of ectopic pregnancy; a published explanation of the model can be found here.

Data regarding the success of the use of the tool is still in the very early stages, but initial findings point to overall success in clinical practice, and thus an improvement in the efficiency and quality of care. All leads at the collaborating clinical sites have previous established working relationships with the research group, including Dr. Shabnam Bobdiwala; there is therefore inbuilt trust that they will maintain the standards of the trial. Furthermore, they are all invested in the development of their own units as leaders in evidence-based care.

PUL consortium progress report

To engage patients and find patient representatives, through forums and learning events, external organisations, such as the Ectopic Pregnancy Trust, will be key as well as the patient information team at Imperial College Healthcare NHS Trust. Plans include a smartphone app that enables ultimate ease of use for the DST by trainees, junior doctors, and clinicians. The ultimate aim of the project is engagement of NICE/ RCOG in changing management guidelines to include the diagnostic protocol.

The App can easily be found in the App Store as shown here, and is already in common use.

For further information on this improvement project, please contact: Shabnam Bobdiwala at s.bobdiwala14@imperial.ac.uk