AI Blind-Sweep Ultrasound for Antenatal Screening by Non-Specialist Health Workers in Rural DR Congo (FS2)

June 24, 2026 updated by: SOIK Corporation Sarl

Diagnostic Accuracy and Implementation Feasibility of AI-Assisted Blind Ultrasound Sweep (SPAQ E-con AI) for Antenatal Screening by Non-Specialist Health Workers in Rural Democratic Republic of the Congo

FS2 evaluates the diagnostic accuracy and implementation feasibility of an AI-assisted blind-sweep obstetric ultrasound (SPAQ E-con AI), operated by trained non-specialist health workers, for antenatal screening in rural Democratic Republic of the Congo. Primary outcomes are gestational age mean absolute error (Trimester 2 and Trimester 3) with 95% confidence intervals and AI confidence calibration. The reference standard is manual measurement by a reference reader (early ultrasound first; manual BPD if unavailable; last menstrual period is not used). Target enrollment is approximately 1,430 (IRB-approved ceiling 3,000), with early termination permitted upon achievement of pre-specified analysis-plan thresholds. The study is a multi-center prospective Hybrid Type 1 Effectiveness-Implementation design and includes a pre-specified adaptive model-update (Batch 2 cut) plan following FDA PCCP and STARD-AI guidance.

Study Overview

Study Type

Observational

Enrollment (Estimated)

3000

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Sampling Method

Non-Probability Sample

Study Population

Pregnant women attending routine antenatal care at participating facilities or identified through community health worker (RECO) village outreach in the Kenge health zone, Kwango province, DRC.

Description

Inclusion Criteria:

  • Pregnant women
  • Identified at a participating facility routine ANC visit or RECO village outreach within the Kenge health zone catchment
  • Informed consent obtained (16-17 years with parent/guardian consent)

Exclusion Criteria:

  • Emergency presentation
  • Multiple pregnancy
  • Duplicate re-registration of an already-enrolled woman
  • Lacking capacity to consent
  • Planned relocation outside Kwango province during the study period
  • Refusal of consent

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Cohort A
Natural enrollment / Description: Consecutive ANC attendees (natural prevalence)
Smartphone-based 9-sweep obstetric ultrasound with AI estimation of gestational age, fetal presentation, and placenta location, operated by trained non-specialist health workers after 30-60 minutes of training.
Cohort B-1 Placenta/malpresentation enriched
Enriched validation subset for placenta praevia and fetal malpresentation
Smartphone-based 9-sweep obstetric ultrasound with AI estimation of gestational age, fetal presentation, and placenta location, operated by trained non-specialist health workers after 30-60 minutes of training.
Cohort B-2 - Trimester 1 (CRL/GS) enriched
Enriched trimester 1 cases for CRL/GS gestational age models
Smartphone-based 9-sweep obstetric ultrasound with AI estimation of gestational age, fetal presentation, and placenta location, operated by trained non-specialist health workers after 30-60 minutes of training.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Gestational age mean absolute error (MAE), Trimester 2 (14-27 weeks)
Time Frame: Through study completion, up to 12 months
MAE in days vs reference standard, with 95% CI; target MAE ≤7 days and upper 95% CI ≤10 days
Through study completion, up to 12 months
Gestational age mean absolute error (MAE), Trimester 3 (28-36 weeks)
Time Frame: Through study completion, up to 12 months
MAE in days vs reference standard, with 95% CI; target MAE ≤10 days and upper 95% CI ≤14 days
Through study completion, up to 12 months
AI confidence calibration - Expected Calibration Error (ECE)
Time Frame: At Batch 1 closure, up to 8 weeks
Expected Calibration Error from the reliability diagram of AI confidence versus reference-standard agreement; target <=0.05
At Batch 1 closure, up to 8 weeks
AI confidence calibration - Brier score
Time Frame: At Batch 1 closure, up to 8 weeks
Brier score of AI confidence versus reference-standard agreement; target <=0.20
At Batch 1 closure, up to 8 weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Trimester 1 gestational age MAE (CRL and GS models)
Time Frame: Through study completion, up to 12 months
Integrated Cohort A T1 + Cohort B-2, N=30; CRL model MAE ≤5 days or GS model MAE ≤7 days
Through study completion, up to 12 months
Placenta praevia and fetal malpresentation sensitivity and specificity
Time Frame: Through study completion, up to 12 months
Observed sensitivity/specificity with 95% CI (Clopper-Pearson) on enriched validation subset (Cohort B-1, target N=20-25); reported as observed values
Through study completion, up to 12 months
Inter-rater reliability of gestational age - Intraclass Correlation Coefficient (ICC)
Time Frame: During the inter-rater assessment window, up to 1 week
ICC(2,1) between two independent readers for gestational age in days
During the inter-rater assessment window, up to 1 week
Inter-rater reliability of placenta praevia classification - Cohen's kappa
Time Frame: During the inter-rater assessment window, up to 1 week
Cohen's kappa for placenta praevia (yes/no) between two independent readers
During the inter-rater assessment window, up to 1 week
Inter-rater reliability of fetal presentation classification - weighted kappa
Time Frame: During the inter-rater assessment window, up to 1 week
Linear weighted kappa for fetal presentation category between two independent readers
During the inter-rater assessment window, up to 1 week
Acceptability - Acceptability of Intervention Measure (AIM) score
Time Frame: Through study completion, up to 12 months
Mean AIM score (4-item, 5-point Likert) among health workers
Through study completion, up to 12 months
Feasibility - ultrasound throughput (scans per device per day)
Time Frame: Through study completion, up to 12 months
Number of scans completed per device per day; target >=15
Through study completion, up to 12 months
Fidelity - protocol adherence rate (5-item checklist)
Time Frame: Through study completion, up to 12 months
Percentage adherence on a 5-item fidelity checklist; target >=80%
Through study completion, up to 12 months
Penetration - proportion of eligible women screened
Time Frame: Through study completion, up to 12 months
Percentage of eligible women in the catchment screened with AI ultrasound
Through study completion, up to 12 months
Sustainability - intention to continue use
Time Frame: At study completion, up to 12 months
Percentage of staff reporting intention to continue use at the end-of-study interview
At study completion, up to 12 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Principal Investigator: Kuniyuki Furuta, SOIK Corporation

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

June 19, 2026

Primary Completion (Estimated)

December 31, 2026

Study Completion (Estimated)

June 13, 2027

Study Registration Dates

First Submitted

June 18, 2026

First Submitted That Met QC Criteria

June 24, 2026

First Posted (Actual)

July 1, 2026

Study Record Updates

Last Update Posted (Actual)

July 1, 2026

Last Update Submitted That Met QC Criteria

June 24, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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