Predictive ability of the Desire to Avoid Pregnancy scale.
Journal
Reproductive health
ISSN: 1742-4755
Titre abrégé: Reprod Health
Pays: England
ID NLM: 101224380
Informations de publication
Date de publication:
25 Sep 2023
25 Sep 2023
Historique:
received:
02
11
2022
accepted:
11
09
2023
medline:
27
9
2023
pubmed:
26
9
2023
entrez:
25
9
2023
Statut:
epublish
Résumé
A longstanding gap in the reproductive health field has been the availability of a screening instrument that can reliably predict a person's likelihood of becoming pregnant. The Desire to Avoid Pregnancy Scale is a new measure; understanding its sensitivity and specificity as a screening tool for pregnancy as well as its predictive ability and how this varies by socio-demographic factors is important to inform its implementation. This analysis was conducted on a cohort of 994 non-pregnant participants recruited in October 2018 and followed up for one year. The cohort was recruited using social media as well as advertisements in a university, school, abortion clinic and outreach sexual health service. Almost 90% of eligible participants completed follow-up at 12 months; those lost to follow-up were not significantly different on key socio-demographic factors. We used baseline DAP score and a binary variable of whether participants experienced pregnancy during the study to assess the sensitivity, specificity, area under the ROC curve (AUROC) and positive and negative predictive values (PPV and NPV) of the DAP at a range of cut-points. We also examined how the predictive ability of the DAP varied according to socio-demographic factors and by the time frame considered (e.g., pregnancy within 3, 6, 9 and 12 months). At a cut-point of 2 on the 0-4 range of the DAP scale, the DAP had a sensitivity of 0.78, a specificity of 0.81 and an excellent AUROC of 0.87. In this sample the cumulative incidence of pregnancy was 16% (95%CI 13%, 18%) making the PPV 43% and the NPV 95% at this cut-point. The DAP score was the factor most strongly associated with pregnancy, even after age and number of children were taken into account. The association between baseline DAP score and pregnancy did not differ across time frames. This is the first study to assess the DAP scale as a screening tool and shows that its predictive ability is superior to the limited pre-existing pregnancy prediction tools. Based on our findings, the DAP could be used with a cut-point selected according to the purpose.
Sections du résumé
BACKGROUND
BACKGROUND
A longstanding gap in the reproductive health field has been the availability of a screening instrument that can reliably predict a person's likelihood of becoming pregnant. The Desire to Avoid Pregnancy Scale is a new measure; understanding its sensitivity and specificity as a screening tool for pregnancy as well as its predictive ability and how this varies by socio-demographic factors is important to inform its implementation.
METHODS
METHODS
This analysis was conducted on a cohort of 994 non-pregnant participants recruited in October 2018 and followed up for one year. The cohort was recruited using social media as well as advertisements in a university, school, abortion clinic and outreach sexual health service. Almost 90% of eligible participants completed follow-up at 12 months; those lost to follow-up were not significantly different on key socio-demographic factors. We used baseline DAP score and a binary variable of whether participants experienced pregnancy during the study to assess the sensitivity, specificity, area under the ROC curve (AUROC) and positive and negative predictive values (PPV and NPV) of the DAP at a range of cut-points. We also examined how the predictive ability of the DAP varied according to socio-demographic factors and by the time frame considered (e.g., pregnancy within 3, 6, 9 and 12 months).
RESULTS
RESULTS
At a cut-point of 2 on the 0-4 range of the DAP scale, the DAP had a sensitivity of 0.78, a specificity of 0.81 and an excellent AUROC of 0.87. In this sample the cumulative incidence of pregnancy was 16% (95%CI 13%, 18%) making the PPV 43% and the NPV 95% at this cut-point. The DAP score was the factor most strongly associated with pregnancy, even after age and number of children were taken into account. The association between baseline DAP score and pregnancy did not differ across time frames.
CONCLUSIONS
CONCLUSIONS
This is the first study to assess the DAP scale as a screening tool and shows that its predictive ability is superior to the limited pre-existing pregnancy prediction tools. Based on our findings, the DAP could be used with a cut-point selected according to the purpose.
Identifiants
pubmed: 37749640
doi: 10.1186/s12978-023-01687-9
pii: 10.1186/s12978-023-01687-9
pmc: PMC10521409
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
144Subventions
Organisme : National Institute for Health and Care Research
ID : PDF-2017-10-021
Informations de copyright
© 2023. BioMed Central Ltd., part of Springer Nature.
Références
Fertil Steril. 1996 Mar;65(3):503-9
pubmed: 8774277
Cancer. 1950 Jan;3(1):32-5
pubmed: 15405679
Med Care. 2019 Feb;57(2):152-158
pubmed: 30550399
BMJ Open. 2022 Jul 25;12(7):e060287
pubmed: 35879004
PLoS One. 2021 Sep 20;16(9):e0257411
pubmed: 34543298
Contraception. 2020 Feb;101(2):79-85
pubmed: 31805265
Hum Reprod. 2003 Sep;18(9):1959-66
pubmed: 12923157
Hum Reprod. 2009 Aug;24(8):1774-8
pubmed: 19395365
Hum Reprod. 2004 Sep;19(9):2019-26
pubmed: 15192070
J Biomed Inform. 2009 Apr;42(2):377-81
pubmed: 18929686
Perspect Sex Reprod Health. 2022 Sep;54(3):90-98
pubmed: 36071572
J Public Health (Oxf). 2016 Sep;38(3):e384-e391
pubmed: 26354998
Int J Environ Res Public Health. 2019 Dec 13;16(24):
pubmed: 31847168
Reprod Biomed Online. 2019 Jan;38(1):77-94
pubmed: 30424937
BMJ Sex Reprod Health. 2023 Jul;49(3):167-175
pubmed: 36717217
Hum Reprod. 2005 Jun;20(6):1636-41
pubmed: 15760951
Hum Reprod. 2007 Feb;22(2):536-42
pubmed: 16997935
Hum Reprod. 2022 Mar 01;37(3):565-576
pubmed: 35024824
J Biomed Inform. 2019 Jul;95:103208
pubmed: 31078660
Women Birth. 2021 Mar;34(2):e153-e161
pubmed: 32312651