OBJECTIVE: To assess utility of a logistic regression model in a US population of womenDESIGN: Validation of prediction of outcome of a pregnancy of unknown location (PUL)MATERIALS AND METHODS: The “M4 model” was developed on cases of PUL from St. George's Hospital, London; prognostic variables included log transformed serum hCG average of 2 measurements, linear and quadratic hCG ratio, with the outcomes of failing PUL, intrauterine pregnancy (IUP) and ectopic pregnancy (EP). (Condous et al. Ultrasound Obstet Gynecol 2007; 29:680-87) The US cohort included patients who presented to the University of Pennsylvania with symptomatic first trimester pregnancy, and were followed until a definitive diagnosis was made: spontaneous abortion (SAB), IUP or EP. The model was applied to the US cohort and its performance was evaluated.TableModel performanceCohortTypeSens(%)Spec(%)AUCUKEP80.088.60.900IUP85.996.30.974Failing PUL87.297.50.978USEP49.087.40.821IUP84.192.80.961SAB81.483.00.933 Open table in a new tab In an attempt to improve performance in the US population by including only PULs and reclassifying US patients based on the British hCG values and ultrasound criteria (data not shown), we were unable to demonstrate an improvement in its performance.CONCLUSIONS: The M4 model is not equivalent in its predictive ability in a US cohort. Specifically, it had a lower AUC for SABs in the US cohort, and although the AUCs for EP were not significantly different, it had poor sensitivity for EP in the US. OBJECTIVE: To assess utility of a logistic regression model in a US population of women DESIGN: Validation of prediction of outcome of a pregnancy of unknown location (PUL) MATERIALS AND METHODS: The “M4 model” was developed on cases of PUL from St. George's Hospital, London; prognostic variables included log transformed serum hCG average of 2 measurements, linear and quadratic hCG ratio, with the outcomes of failing PUL, intrauterine pregnancy (IUP) and ectopic pregnancy (EP). (Condous et al. Ultrasound Obstet Gynecol 2007; 29:680-87) The US cohort included patients who presented to the University of Pennsylvania with symptomatic first trimester pregnancy, and were followed until a definitive diagnosis was made: spontaneous abortion (SAB), IUP or EP. The model was applied to the US cohort and its performance was evaluated. In an attempt to improve performance in the US population by including only PULs and reclassifying US patients based on the British hCG values and ultrasound criteria (data not shown), we were unable to demonstrate an improvement in its performance. CONCLUSIONS: The M4 model is not equivalent in its predictive ability in a US cohort. Specifically, it had a lower AUC for SABs in the US cohort, and although the AUCs for EP were not significantly different, it had poor sensitivity for EP in the US.