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Working towards a risk prediction model for neural tube defects
A J Agopian1, Philip J Lupo, Sarah C Tinker
1Human Genetics Center, Division of Epidemiology, Human Genetics and Environmental Sciences, University of Texas School of Public Health, Houston, Texas 77030, USA.
Birth Defects Research. Part A, Clinical and Molecular Teratology
|January 19, 2012
Summary
Established risk factors for neural tube defects (NTDs) are insufficient for predicting risk in pregnant women. New genetic and nongenetic factors are needed to improve NTD prediction models.
Area of Science:
- Epidemiology
- Reproductive Health
- Genetics
Background:
- Neural tube defects (NTDs) are birth defects with several known risk factors.
- The combined predictive power of these risk factors for NTDs has not been previously assessed.
Purpose of the Study:
- To evaluate the predictive ability of established risk factors for neural tube defects (NTDs).
- To assess the utility of multivariable logistic regression, ordinal risk indexes, and classification and regression tree (CART) analysis in predicting NTDs.
Main Methods:
- Utilized data from the National Birth Defects Prevention Study (NBDPS).
- Developed predictive models using logistic regression, ordinal risk indexes, and CART analysis on training samples (75% of cases and controls).
- Validated model predictive ability using area under the receiver operator characteristic curves in independent validation samples (25% of cases and controls).
Main Results:
- Multivariable models demonstrated poor predictive ability for NTDs (area under the curve ranged from 0.55 to 0.59).
- Ordinal risk indexes and CART models also showed low predictive accuracy for identifying women at increased risk.
- Current risk factors are inadequate for population-level NTD risk prediction.
Conclusions:
- Established risk factors alone are insufficient for accurate population-level prediction of NTDs.
- Future research must focus on identifying novel genetic and nongenetic risk factors.
- Improved predictive models are crucial for effective NTD prevention strategies.
