Table I.6.3GRADE findings for accuracy of diagnosing ectopic pregnancy using transvaginal or transabdominal ultrasound

Quality assessmentNumber of womenMeasure of diagnostic accuracyQuality
Number of studiesDesignLimitationsInconsistencyIndirectnessImprecisionOther considerationsSensitivitySpecificityPositive predictive valueNegative predictive valuePositive likelihood ratioNegative likelihood ratio
Transvaginal ultrasound
1 study

(Shapiro et al., 1988)
Prospective studyserious1,2no serious inconsistencyserious3serious4None2590

(78 to 100)*
33

(20 to 86)*
90

(78 to 100)*
33

(20 to 86)*
1.36

(0.60 to 3.06)*
0.27

(0.05 to 2.17)*
Very low
1 study

(Thorsen et al., 1990)
Prospective studyserious5no serious inconsistencyno serious indirectnessno serious imprecisionNone19338

26 t 50)*
100

(100 to 100)*
100

(100 to 100)*
78

(72 to 84)*
infinity*0.6

(0.50 to 0.75) *
Moderate
1 study

(Kivikoski et al., 1990)
Prospective studyserious5no serious inconsistencyno serious indirectnessserious4None3472

(56 t 90)*
100

(100 to 100)*
100

(100 to 100)*
53

(28 to 78)*
infinity*0.26

(0.14 to 0.50)
Low
Transabdominal ultrasound
1 study

(Shapiro et al., 1988)
Prospective studyserious1,2,no serious inconsistencyserious3serious4None2550

(29 to 70)*
Not calculable (NC)NCNCNCNCVery low
1 study

(Thorsen et al., 1990)
Prospective studyserious5no serious inconsistencyno serious indirectnessno serious imprecisionNone19321

(11 to 32)*
100

(100 to 100)*
100

(100 to 100)*
73

(67 to 80)*
infinity*0.7*

(0.67 to 0.89
Moderate
1 study

(Kivikoski et al., 1990)
Prospective studyserious5no serious inconsistencyno serious indirectnessserious4None3444

(25 to 63)*
100

(100 to 100)*
100

(100 to 100)*
31

(12 to 51)*
infinity*0.55

(0.39 to 77)*
Low
*

NCC calculation

1

Exclusion criteria not reported

2

No information about the type of surgery that was used as reference standard is given

3

Diagnosis accuracy of transabdominal not fully reported

4

Small sample size

5

In most cases the ultrasonographer was not blinded to the result of the prior ultrasound

From: Appendix I, GRADE tables

Cover of Ectopic Pregnancy and Miscarriage
Ectopic Pregnancy and Miscarriage: Diagnosis and Initial Management in Early Pregnancy of Ectopic Pregnancy and Miscarriage.
NICE Clinical Guidelines, No. 154.
National Collaborating Centre for Women's and Children's Health (UK).
London: RCOG; 2012 Dec.
Copyright © 2012, National Collaborating Centre for Women's and Children's Health.

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