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Ectopic Pregnancy: Likelihood Ratios

Introduction: See Pregnancy for beta-hCG diagnostic test accuracies.

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Prevalence

Population / Calculator	Prevalence	Comments / Study / Link
Pregnancies	2%	http://www.utdol.com/online/content/topic.do?topicKey=gen_gyne/6639
Women presenting to ED with first trimester bleeding, pain, or both	12%	6-16% http://www.utdol.com/online/content/topic.do?topicKey=gen_gyne/6639
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The likelihood ratios of findings for Ectopic Pregnancy are listed below. See the left navigation bar to change the display.

Pre-Test Probability (Prevalence): %.	Post-Test Probability (Predictive Value): %.	Switch to display mode.
Note that calculating probabilities from more than one** finding is inherently inaccurate because findings are not independent. (For example, using two positive findings that share a common pathogenesis is likely to overestimate the true probability.)

Good Positive and Negative Likelihood Ratios
Finding	Result	+LR	-LR
[ + ] Trans-Vaginal Ultrasound	+ 0 -	inf	0.3
spec = 99.9%. Diagnostic criteria included sonographic evidence of an empty intrauterine cavity and adnexal mass and/or extrauterine gestational sac. For all patients where the diagnosis was "pregnancy of unknown location", ectopic pregnancy was later confirmed Study: Hum Reprod. 2007 Nov;22(11):2824-8. PMID 17855406

Good Positive Likelihood Ratio
Finding	Result	+LR	-LR
[ + ] Cervical motion tenderness	+ 0 -	5	0.6
Study: Crochet, J. R., Bastian, L. A., & Chireau, M. V. (2013). Does This Woman Have an Ectopic Pregnancy? JAMA, 309(16), 1722. doi:10.1001/jama.2013.3914
[ + ] Adnexal Mass	+ 0 -	2.3	0.9
Study: Crochet, J. R., Bastian, L. A., & Chireau, M. V. (2013). Does This Woman Have an Ectopic Pregnancy? JAMA, 309(16), 1722. doi:10.1001/jama.2013.3914

Poorly Diagnostic Findings
Finding	Result	+LR	-LR
[ + ] Adnexal tenderness	+ 0 -	1.7	0.6
Study: Crochet, J. R., Bastian, L. A., & Chireau, M. V. (2013). Does This Woman Have an Ectopic Pregnancy? JAMA, 309(16), 1722. doi:10.1001/jama.2013.3914