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

10. september 2026 oppdatert av: 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). Planned enrollment is approximately 1,380: Batch 1 (closed, 80 enrolled) and Batch 2 (approximately 1,300), within an IRB-approved ceiling of 3,000. Early termination is 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.

Studieoversikt

Status

Rekruttering

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

Study conduct is organised in Batches. Batch 1 (Centre de Sante CBCO, Kenge health zone, Kwango province) enrolled 80 participants, of whom 78 had complete datasets, and is closed. Batch 2 is planned at approximately 1,300 participants. The confirmatory analysis cut is approximately 130 to 160 cases acquired with a model frozen before collection, comprising a core set of 80 to 100, an early-gestation enrichment of 25 to 30, and an upper-gestational-age enrichment of 25 to 30. Enrolment may stop early once the pre-specified confidence-interval criteria for the two primary gestational-age outcomes are met. The registered enrolment ceiling of 3,000 is unchanged.

Sites are facilities of the Kenge health zone, Kwango province, within the perimeter already approved in the protocol (up to 6 facilities plus 2 to 5 village outreach sites).

Eligibility follows the protocol: pregnant women aged 18 years or older. Multiple pregnancies are eligible.

Two sub-cohorts address the bounds of the gestational-age range. The early sub-cohort (crown-rump length 7 to 84 mm, approximately under 14 weeks) draws on the same source population as Cohort B-2 and is recruited through community health worker (RECO) village outreach and neighbouring health facilities; it is reported descriptively. The upper-bound sub-cohort (35 weeks or more) is a separate validation subset, recruited in parallel and analysed separately; sensitivity and specificity are reported, and positive and negative predictive values are not reported because prevalence in this subset is artificial.

The registered Trimester 3 estimation window (28 to 36 weeks) is unchanged. In Batch 2, point estimates are reported for 28 to 34 weeks, and 35 to 36 weeks is handled as "to be confirmed / refer". This is an operational reporting restriction, not a change to the registered window.

The AI model is identified and frozen before each Batch and recorded in a model and application version registry under a pre-determined change control plan. Results are reported by frozen version. AI inference is not used for clinical decision-making.

Studietype

Observasjonsmessig

Registrering (Antatt)

3000

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

Studiesteder

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Ja

Prøvetakingsmetode

Ikke-sannsynlighetsprøve

Studiepopulasjon

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.

Beskrivelse

Inclusion Criteria:

  • Pregnant women aged 18 years or older
  • Identified at a participating facility routine ANC visit or RECO village outreach within the Kenge health zone catchment
  • Written informed consent obtained

Exclusion Criteria:

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

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

Kohorter og intervensjoner

Gruppe / Kohort
Intervensjon / Behandling
Cohort A
Natural enrollment / Description: Consecutive ANC attendees (natural prevalence)
Diagnostisk test: SPAQ E-con AI blind-sweep ultrasound
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. The AI model is frozen before each Batch and managed in a version registry under a pre-determined change control plan (PCCP); AI inference is not used for clinical decision-making.
Cohort B-1 Placenta/malpresentation enriched
Enriched validation subset for placenta praevia and fetal malpresentation
Diagnostisk test: SPAQ E-con AI blind-sweep ultrasound
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. The AI model is frozen before each Batch and managed in a version registry under a pre-determined change control plan (PCCP); AI inference is not used for clinical decision-making.
Cohort B-2 - Trimester 1 (CRL/GS) enriched
Enriched trimester 1 cases for CRL/GS gestational age models
Diagnostisk test: SPAQ E-con AI blind-sweep ultrasound
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. The AI model is frozen before each Batch and managed in a version registry under a pre-determined change control plan (PCCP); AI inference is not used for clinical decision-making.
Cohort B-3 - Early gestation (CRL 7-84 mm) enriched
Early-gestation enrichment sub-cohort: crown-rump length 7-84 mm, approximately under 14 weeks of gestation. Drawn from the same source population as Cohort B-2 and recruited through community health worker (RECO) village outreach and neighbouring health facilities. Reported descriptively.
Diagnostisk test: SPAQ E-con AI blind-sweep ultrasound
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. The AI model is frozen before each Batch and managed in a version registry under a pre-determined change control plan (PCCP); AI inference is not used for clinical decision-making.
Cohort B-4 - Upper gestational-age bound (>=35 weeks) validation subset
Validation subset at the upper bound of the gestational-age range (35 weeks of gestation or more), recruited in parallel with the main cohort and analysed separately. Sensitivity and specificity are reported. Positive and negative predictive values are not reported, because prevalence in this subset is artificial.
Diagnostisk test: SPAQ E-con AI blind-sweep ultrasound
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. The AI model is frozen before each Batch and managed in a version registry under a pre-determined change control plan (PCCP); AI inference is not used for clinical decision-making.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Gestational age mean absolute error (MAE), Trimester 2 (14-27 weeks)
Tidsramme: 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)
Tidsramme: 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)
Tidsramme: 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
Tidsramme: 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

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Trimester 1 gestational age MAE (CRL and GS models)
Tidsramme: 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
Tidsramme: 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)
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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)
Tidsramme: 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)
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

SOIK Corporation Sarl

Etterforskere

  • Hovedetterforsker: Kuniyuki Furuta, SOIK Corporation

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

19. juni 2026

Primær fullføring (Antatt)

31. desember 2026

Studiet fullført (Antatt)

13. juni 2027

Datoer for studieregistrering

Først innsendt

18. juni 2026

Først innsendt som oppfylte QC-kriteriene

24. juni 2026

Først lagt ut (Faktiske)

1. juli 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

15. september 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

10. september 2026

Sist bekreftet

1. september 2026

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • SOIK-FS2-2026

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Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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