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

10 september 2026 uppdaterad 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.

Studieöversikt

Status

Rekrytering

Betingelser

Intervention / Behandling

Detaljerad beskrivning

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.

Studietyp

Observationell

Inskrivning (Beräknad)

3000

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studiekontakt

Studieorter

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

  • Vuxen
  • Äldre vuxen

Tar emot friska volontärer

Ja

Testmetod

Icke-sannolikhetsprov

Studera befolkning

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.

Beskrivning

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

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

Kohorter och interventioner

Grupp / Kohort
Intervention / Behandling
Cohort A
Natural enrollment / Description: Consecutive ANC attendees (natural prevalence)
Diagnostiskt 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
Diagnostiskt 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
Diagnostiskt 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.
Diagnostiskt 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.
Diagnostiskt 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.

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Gestational age mean absolute error (MAE), Trimester 2 (14-27 weeks)
Tidsram: 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)
Tidsram: 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)
Tidsram: 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
Tidsram: 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

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Trimester 1 gestational age MAE (CRL and GS models)
Tidsram: 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
Tidsram: 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)
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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)
Tidsram: 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)
Tidsram: 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
Tidsram: 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
Tidsram: 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

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

SOIK Corporation Sarl

Utredare

  • Huvudutredare: Kuniyuki Furuta, SOIK Corporation

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Faktisk)

19 juni 2026

Primärt slutförande (Beräknad)

31 december 2026

Avslutad studie (Beräknad)

13 juni 2027

Studieregistreringsdatum

Först inskickad

18 juni 2026

Först inskickad som uppfyllde QC-kriterierna

24 juni 2026

Första postat (Faktisk)

1 juli 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

15 september 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

10 september 2026

Senast verifierad

1 september 2026

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • SOIK-FS2-2026

Plan för individuella deltagardata (IPD)

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