Specialist commentator comments

Comments on this technology were invited from clinical specialists working in the field and relevant patient organisations. The comments received are individual opinions and do not represent NICE's view.

Four specialists were involved in the production of this briefing. Three specialists are familiar with the product, 1 of which has used the technology. One specialist is unfamiliar with the technology.

Level of innovation

Three specialists consider the concept to be novel and convenient for patients, 1 of whom states there are currently no tests for use outside of a secondary care setting. Two specialists commented that some trusts use diagnostic biomarker tests following an inconclusive speculum examination. One welcomes the technology for the use of excluding ruptured membranes and reducing hospital referrals.

Potential patient impact

Two specialists believe the technology would be beneficial to all women with vaginal wetness, another believes the technology would benefit all women in their third trimester. Three commented that the technology would give women confidence and reassurance. Three specialists believe the technology would result in fewer unnecessary journeys to hospitals for intimate procedures. Two consider the technology to be particularly useful for women at risk of preterm labour.

Potential system impact

Three specialists think the technology would result in a decrease in unnecessary speculum examinations and fewer referrals to secondary care. Two believe the technology will likely result in an increase in staff capacity resulting in cost savings, 1 commented that bed availability will be increased and the other believes the technology will be time saving. One thinks false positives could result in increased stress for women as well as cost increases because of further investigations and increased consultant time. One feels unable to speculate about the cost-saving potential without figures detailing the number of cases of unnecessary speculum examinations.

General comments

One specialist feels further evidence is needed to confirm the most recent version of the technology is as reliable as the versions used in the evidence base. One specialist raises concerns that the sensitivity and specificity is less than 100% and feels the technology should be used with the assistance of midwives and further investigations to be completed if symptoms continue. One raises concerns about the effect of tap water on the test result. The user instructions say tap water can interfere with test results and a retest should be done if wetness is related to recent bathing. One specialist supports the technology provided women have robust training in using the product.