Identifying subfertile ovulatory women for timely tubal patency testing: A clinical decision rule based on medical history

S. F P J Coppus, H. R. Verhoeve, B. C. Opmeer, J. W. Van der Steeg, P. Steures, M. J C Eijkemans, P. G A Hompes, P. M M Bossuyt, F. Van der Veen, B. W J Mol

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: The aim of tubal testing is to identify women with bilateral tubal pathology in a timely manner, so they can be treated with IVF or tubal surgery. At present, it is unclear for which women early tubal testing is indicated, and in whom it can be deferred. Methods: Data on 3716 women who underwent tubal patency testing as a part of their routine fertility workup were used to relate elements in their medical history to the presence of tubal pathology. With multivariable logistic regression, we constructed two diagnostic models. One in which tubal disease was defined as occlusion and/or severe adhesions of at least one tube, whereas in a second model, tubal disease was defined as the presence of bilateral abnormalities. Results: Both models discriminated moderately well between women with and women without tubal disease with an area under the receiver-operating characteristic curve (AUC) of 0.65 (95% CI: 0.63-0.68) for any tubal pathology and 0.68 (95% CI: 0.65-0.71) for bilateral tubal pathology, respectively. However, the models could make an almost perfect distinction between women with a high and a low probability of tubal pathology. A decision rule in the form of a simple diagnostic score chart was developed for application of the models in clinical practice. Conclusions: In conclusion, the present study provides two easy to use decision rules that can accurately express a woman's probability of (severe) tubal pathology at the couple's first consultation. They could be used to select women for tubal testing more efficiently.

LanguageEnglish
Pages2685-2692
Number of pages8
JournalHuman Reproduction
Volume22
Issue number10
DOIs
Publication statusPublished - 1 Jan 2007

Keywords

  • Clinical decision rule
  • Medical history
  • Tubal patency testing
  • Tubal pathology

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynaecology

Cite this

Coppus, S. F. P. J., Verhoeve, H. R., Opmeer, B. C., Van der Steeg, J. W., Steures, P., Eijkemans, M. J. C., ... Mol, B. W. J. (2007). Identifying subfertile ovulatory women for timely tubal patency testing: A clinical decision rule based on medical history. Human Reproduction, 22(10), 2685-2692. https://doi.org/10.1093/humrep/dem251
Coppus, S. F P J ; Verhoeve, H. R. ; Opmeer, B. C. ; Van der Steeg, J. W. ; Steures, P. ; Eijkemans, M. J C ; Hompes, P. G A ; Bossuyt, P. M M ; Van der Veen, F. ; Mol, B. W J. / Identifying subfertile ovulatory women for timely tubal patency testing : A clinical decision rule based on medical history. In: Human Reproduction. 2007 ; Vol. 22, No. 10. pp. 2685-2692.
@article{7002b3fd23c44de5bfd46ec295227657,
title = "Identifying subfertile ovulatory women for timely tubal patency testing: A clinical decision rule based on medical history",
abstract = "Background: The aim of tubal testing is to identify women with bilateral tubal pathology in a timely manner, so they can be treated with IVF or tubal surgery. At present, it is unclear for which women early tubal testing is indicated, and in whom it can be deferred. Methods: Data on 3716 women who underwent tubal patency testing as a part of their routine fertility workup were used to relate elements in their medical history to the presence of tubal pathology. With multivariable logistic regression, we constructed two diagnostic models. One in which tubal disease was defined as occlusion and/or severe adhesions of at least one tube, whereas in a second model, tubal disease was defined as the presence of bilateral abnormalities. Results: Both models discriminated moderately well between women with and women without tubal disease with an area under the receiver-operating characteristic curve (AUC) of 0.65 (95{\%} CI: 0.63-0.68) for any tubal pathology and 0.68 (95{\%} CI: 0.65-0.71) for bilateral tubal pathology, respectively. However, the models could make an almost perfect distinction between women with a high and a low probability of tubal pathology. A decision rule in the form of a simple diagnostic score chart was developed for application of the models in clinical practice. Conclusions: In conclusion, the present study provides two easy to use decision rules that can accurately express a woman's probability of (severe) tubal pathology at the couple's first consultation. They could be used to select women for tubal testing more efficiently.",
keywords = "Clinical decision rule, Medical history, Tubal patency testing, Tubal pathology",
author = "Coppus, {S. F P J} and Verhoeve, {H. R.} and Opmeer, {B. C.} and {Van der Steeg}, {J. W.} and P. Steures and Eijkemans, {M. J C} and Hompes, {P. G A} and Bossuyt, {P. M M} and {Van der Veen}, F. and Mol, {B. W J}",
year = "2007",
month = "1",
day = "1",
doi = "10.1093/humrep/dem251",
language = "English",
volume = "22",
pages = "2685--2692",
journal = "Human Reproduction",
issn = "0268-1161",
publisher = "Oxford University Press",
number = "10",

}

Coppus, SFPJ, Verhoeve, HR, Opmeer, BC, Van der Steeg, JW, Steures, P, Eijkemans, MJC, Hompes, PGA, Bossuyt, PMM, Van der Veen, F & Mol, BWJ 2007, 'Identifying subfertile ovulatory women for timely tubal patency testing: A clinical decision rule based on medical history', Human Reproduction, vol. 22, no. 10, pp. 2685-2692. https://doi.org/10.1093/humrep/dem251

Identifying subfertile ovulatory women for timely tubal patency testing : A clinical decision rule based on medical history. / Coppus, S. F P J; Verhoeve, H. R.; Opmeer, B. C.; Van der Steeg, J. W.; Steures, P.; Eijkemans, M. J C; Hompes, P. G A; Bossuyt, P. M M; Van der Veen, F.; Mol, B. W J.

In: Human Reproduction, Vol. 22, No. 10, 01.01.2007, p. 2685-2692.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Identifying subfertile ovulatory women for timely tubal patency testing

T2 - Human Reproduction

AU - Coppus, S. F P J

AU - Verhoeve, H. R.

AU - Opmeer, B. C.

AU - Van der Steeg, J. W.

AU - Steures, P.

AU - Eijkemans, M. J C

AU - Hompes, P. G A

AU - Bossuyt, P. M M

AU - Van der Veen, F.

AU - Mol, B. W J

PY - 2007/1/1

Y1 - 2007/1/1

N2 - Background: The aim of tubal testing is to identify women with bilateral tubal pathology in a timely manner, so they can be treated with IVF or tubal surgery. At present, it is unclear for which women early tubal testing is indicated, and in whom it can be deferred. Methods: Data on 3716 women who underwent tubal patency testing as a part of their routine fertility workup were used to relate elements in their medical history to the presence of tubal pathology. With multivariable logistic regression, we constructed two diagnostic models. One in which tubal disease was defined as occlusion and/or severe adhesions of at least one tube, whereas in a second model, tubal disease was defined as the presence of bilateral abnormalities. Results: Both models discriminated moderately well between women with and women without tubal disease with an area under the receiver-operating characteristic curve (AUC) of 0.65 (95% CI: 0.63-0.68) for any tubal pathology and 0.68 (95% CI: 0.65-0.71) for bilateral tubal pathology, respectively. However, the models could make an almost perfect distinction between women with a high and a low probability of tubal pathology. A decision rule in the form of a simple diagnostic score chart was developed for application of the models in clinical practice. Conclusions: In conclusion, the present study provides two easy to use decision rules that can accurately express a woman's probability of (severe) tubal pathology at the couple's first consultation. They could be used to select women for tubal testing more efficiently.

AB - Background: The aim of tubal testing is to identify women with bilateral tubal pathology in a timely manner, so they can be treated with IVF or tubal surgery. At present, it is unclear for which women early tubal testing is indicated, and in whom it can be deferred. Methods: Data on 3716 women who underwent tubal patency testing as a part of their routine fertility workup were used to relate elements in their medical history to the presence of tubal pathology. With multivariable logistic regression, we constructed two diagnostic models. One in which tubal disease was defined as occlusion and/or severe adhesions of at least one tube, whereas in a second model, tubal disease was defined as the presence of bilateral abnormalities. Results: Both models discriminated moderately well between women with and women without tubal disease with an area under the receiver-operating characteristic curve (AUC) of 0.65 (95% CI: 0.63-0.68) for any tubal pathology and 0.68 (95% CI: 0.65-0.71) for bilateral tubal pathology, respectively. However, the models could make an almost perfect distinction between women with a high and a low probability of tubal pathology. A decision rule in the form of a simple diagnostic score chart was developed for application of the models in clinical practice. Conclusions: In conclusion, the present study provides two easy to use decision rules that can accurately express a woman's probability of (severe) tubal pathology at the couple's first consultation. They could be used to select women for tubal testing more efficiently.

KW - Clinical decision rule

KW - Medical history

KW - Tubal patency testing

KW - Tubal pathology

UR - http://www.scopus.com/inward/record.url?scp=34548794760&partnerID=8YFLogxK

U2 - 10.1093/humrep/dem251

DO - 10.1093/humrep/dem251

M3 - Article

VL - 22

SP - 2685

EP - 2692

JO - Human Reproduction

JF - Human Reproduction

SN - 0268-1161

IS - 10

ER -

Coppus SFPJ, Verhoeve HR, Opmeer BC, Van der Steeg JW, Steures P, Eijkemans MJC et al. Identifying subfertile ovulatory women for timely tubal patency testing: A clinical decision rule based on medical history. Human Reproduction. 2007 Jan 1;22(10):2685-2692. https://doi.org/10.1093/humrep/dem251