External validation of a simple risk score based on the ASPRE trial algorithm for preterm pre‐eclampsia considering maternal characteristics in nulliparous pregnant women: a multicentre retrospective cohort study
| Autor: | Elena Brunelli, Danila Morano, Chiara Germano, Daniela Di Martino, Bianca Masturzo, Federico Prefumo, Nicola Rizzo, Anna Seidenari, Paolo Cavoretto, Antonio Farina |
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| Přispěvatelé: | Brunelli E., Seidenari A., Germano C., Prefumo F., Cavoretto P., Di Martino D., Masturzo B., Morano D., Rizzo N., Farina A. |
| Rok vydání: | 2020 |
| Předmět: |
Adult
aspirin Population Predictive Value of Test first-trimester algorithm multivariable analysis pre-eclampsia prediction screening Risk Assessment Likelihood ratios in diagnostic testing 03 medical and health sciences 0302 clinical medicine Pre-Eclampsia Retrospective Studie Predictive Value of Tests Pregnancy Early Diagnosi Humans Medicine education multivariable analysi Retrospective Studies education.field_of_study 030219 obstetrics & reproductive medicine Framingham Risk Score Receiver operating characteristic business.industry Obstetrics and Gynecology Retrospective cohort study Pregnancy Trimester First Early Diagnosis Italy Case-Control Studies Predictive value of tests Female Case-Control Studie Risk assessment business Algorithm Algorithms Human Cohort study |
| Zdroj: | BJOG: An International Journal of Obstetrics & Gynaecology. 127:1210-1215 |
| ISSN: | 1471-0528 1470-0328 |
| DOI: | 10.1111/1471-0528.16246 |
| Popis: | Objective: To validate the performance of a first-trimester simple risk score based on the ASPRE trial algorithm for pre-eclampsia. Design: Multicentre retrospective cohort analysis. Setting: Four Italian hospitals. Population: Unselected nulliparous women at 11–13weeks of gestation from January 2014 through to January 2018. Methods: Model performance was evaluated based on discrimination and calibration. Main outcome measures: Delivery before 37weeks of gestation with a diagnosis of pre-eclampsia. Results: Based on 73 preterm pre-eclampsia cases and 7546 controls (including 101 cases of late pre-eclampsia), the area under the receiver operating characteristics curve was 0.659 (95% CI 0.579–0.726). The sensitivity was 32.9% (95% CI 22.1–43.7) at a false-positive rate of 8.8%. The positive likelihood ratio was 3.74 (95% CI 2.67–5.23), the positive predictive value was 3.49% (95% CI 2.12–4.86%) and the negative predictive value was 99.3% (95% CI 99.1–99.5%). The sensitivity and positive likelihood ratio were approximately 40% lower than in the original study. The calibration analysis showed a good agreement between observed and expected risks (P=0.037). Comparison with the Fetal Medicine Foundation (FMF) algorithm yielded a difference in the area under the curve of 0.084 (P=0.007). Conclusions: In our Italian population, the simple risk score had a lower performance than expected for the prediction of preterm pre-eclampsia in nulliparous women. The FMF algorithm applied to the same data set resulted in a better prediction. Tweetable abstract: Simple risk score predicts preterm pre-eclampsia in Italy. |
| Databáze: | OpenAIRE |
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