title: Influence of the sFlt-1/PlGF Ratio on Clinical Decision-Making in Women with Suspected Preeclampsia.
abstract: To evaluate the influence of the soluble fms-like tyrosine kinase 1/placental growth factor ratio in physicians' decision making in pregnant women with signs and symptoms of preeclampsia in routine clinical practice.
  
  
  
  A multicenter, prospective, open, non-interventional study enrolled pregnant women presenting with preeclampsia signs and symptoms in several European perinatal care centers. Before the soluble fms-like tyrosine kinase 1/placental growth factor ratio result was known, physicians documented intended clinical procedures using an iPad® application (data locked/time stamped). After the result was available, clinical decisions were confirmed or revised and documented. An independent adjudication committee evaluated the appropriateness of decisions based on maternal/fetal outcomes. Clinician decision making with regard to hospitalization was the primary outcome.
  
  
  
  In 16.9% of mothers (20/118) the hospitalization decision was changed after knowledge of the ratio. In 13 women (11.0%), the initial decision to hospitalize was changed to no hospitalization. In seven women (5.9%) the revised decision was hospitalization. All revised decisions were considered appropriate by the panel of adjudicators (McNemar test; p < 0.0001).
  
  
  
  The use of the soluble fms-like tyrosine kinase 1/placental growth factor test influenced clinical decision making towards appropriate hospitalization in a considerable proportion of women with suspected preeclampsia. This is the first study to demonstrate the impact of angiogenic biomarkers on decision making in a routine clinical practice.
authors.affiliation: Department of Gynecology and Obstetrics, Klinikum Rechts der Isar, TU München, Munich, Germany.
authors.forename: Evelyn
authors.initials: E
authors.lastname: Klein
authors.affiliation: Dept. of Obstetrics, University Hospital, Jena, Germany.
authors.forename: Dietmar
authors.initials: D
authors.lastname: Schlembach
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital of Innsbruck, Innsbruck, Austria.
authors.forename: Angela
authors.initials: A
authors.lastname: Ramoni
authors.affiliation: Department of Obstetrics, Leipzig University, Leipzig, Germany.
authors.forename: Elena
authors.initials: E
authors.lastname: Langer
authors.affiliation: Department of Obstetrics, Bürgerhospital, Frankfurt, Germany.
authors.forename: Franz
authors.initials: F
authors.lastname: Bahlmann
authors.affiliation: Department of Gynecology and Obstetrics, Klinikum Rechts der Isar, TU München, Munich, Germany.
authors.forename: Sabine
authors.initials: S
authors.lastname: Grill
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital of Innsbruck, Innsbruck, Austria.
authors.forename: Helene
authors.initials: H
authors.lastname: Schaffenrath
authors.affiliation: IST GmbH, Mannheim, Germany.
authors.forename: Reinhard
authors.initials: R
authors.lastname: van der Does
authors.affiliation: IST GmbH, Mannheim, Germany.
authors.forename: Diethelm
authors.initials: D
authors.lastname: Messinger
authors.affiliation: Medical and Scientific Affairs, Roche Diagnostics International Ltd, Rotkreuz, Switzerland.
authors.forename: Wilma D J
authors.initials: WD
authors.lastname: Verhagen-Kamerbeek
authors.affiliation: Medical and Scientific Affairs, Roche Diagnostics GmbH, Penzberg, Germany.
authors.forename: Manfred
authors.initials: M
authors.lastname: Reim
authors.affiliation: Medical and Scientific Affairs, Roche Diagnostics International Ltd, Rotkreuz, Switzerland.
authors.forename: Martin
authors.initials: M
authors.lastname: Hund
authors.affiliation: Department of Obstetrics, Leipzig University, Leipzig, Germany.
authors.forename: Holger
authors.initials: H
authors.lastname: Stepan
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D000066491:Clinical Decision-Making / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D000072483:Placenta Growth Factor / Q000378:metabolism*; D011225:Pre-Eclampsia / Q000175:diagnosis* / Q000628:therapy*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000628:therapy*; D011446:Prospective Studies; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000378:metabolism*; D055815:Young Adult
chemical_list: D015415:Biomarkers; C000608036:PGF protein, human; D000072483:Placenta Growth Factor; C501162:FLT1 protein, human; D040281:Vascular Endothelial Growth Factor Receptor-1