Comparison of the discriminatory accuracy of four risk criteria for preeclampsia.

Autor: Cordero-Franco HF; Unidad de Investigación Epidemiológica y en Servicios de Salud/CIBIN, Delegación Nuevo León, Instituto Mexicano del Seguro Social, Mexico; Universidad Autónoma de Nuevo León, Facultad de Medicina, Mexico. Electronic address: hid.cordero@imss.gob.mx., Salinas-Martínez AM; Unidad de Investigación Epidemiológica y en Servicios de Salud/CIBIN, Delegación Nuevo León, Instituto Mexicano del Seguro Social, Mexico; Universidad Autónoma de Nuevo León, Facultad de Salud Pública y Nutrición, Mexico., García-Alvarez TA; Servicio de Atención Familiar, Unidad de Medicina Familiar No. 31, Instituto Mexicano del Seguro Social, Nuevo León, Mexico., Medina-Franco GE; Unidad de Investigación Epidemiológica y en Servicios de Salud/CIBIN, Delegación Nuevo León, Instituto Mexicano del Seguro Social, Mexico., Guzmán-de la Garza FJ; Unidad de Investigación Epidemiológica y en Servicios de Salud/CIBIN, Delegación Nuevo León, Instituto Mexicano del Seguro Social, Mexico; Universidad Autónoma de Nuevo León, Facultad de Medicina, Mexico., Díaz-Sánchez O; Servicio de Atención Familiar, Unidad de Medicina Familiar No. 31, Instituto Mexicano del Seguro Social, Nuevo León, Mexico., Ramírez-Sandoval G; Servicio de Atención Familiar, Unidad de Medicina Familiar No. 31, Instituto Mexicano del Seguro Social, Nuevo León, Mexico.
Jazyk: angličtina
Zdroj: Pregnancy hypertension [Pregnancy Hypertens] 2018 Jul; Vol. 13, pp. 161-165. Date of Electronic Publication: 2018 Jun 09.
DOI: 10.1016/j.preghy.2018.06.007
Abstrakt: Objectives: Several criteria have been proposed to categorize the risk of preeclampsia, with notable differences between these criteria. We compared the discriminatory accuracy of criteria for categorizing preeclampsia risk established by four institutions, namely, the World Health Organization (WHO), National Institute for Health and Care Excellence (NICE), American College of Obstetricians and Gynecologists (ACOG), and National Center for Technological Excellence in Health (CENETEC), and estimated the concordance between these criteria.
Study Design: We performed a secondary data analysis of 590 Mexican obstetric patients who received prenatal care in primary care between 2016 and 2017; 160 had a diagnosis of preeclampsia.
Main Outcome Measures: We estimated the true (TP) and false positive (FP) fractions, positive (PPV) and negative predictive values (NPV), positive (LR+) and negative (LR-) likelihood ratios, diagnostic odds ratio (DOR), area under the receiver operating characteristic curve (AUROC), and Kappa coefficient with corresponding 95% confidence intervals (CIs).
Results: Only the WHO criteria, followed by the NICE criteria, had the greatest number of accuracy indicators with ideal or acceptable results: TP 83.6%, PPV 60.5%, NPV 90.3%, DOR 14.3, and AUROC 0.79 and TP 84.5%, PPV 51.0%, NPV 90.3%, DOR 9.7, and AUROC 0.74, respectively. The Kappa coefficient between WHO and NICE criteria was 0.78 (95% CI 0.71-0.85).
Conclusions: The discriminatory accuracies of the WHO and NICE criteria were superior to those of the ACOG and CENETEC criteria for classifying preeclampsia risk. Their concordance was good; thus, both criteria seem appropriate for screening preeclampsia in primary care.
(Copyright © 2018 International Society for the Study of Hypertension in Pregnancy. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: