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Prognostic model for predicting survival in very preterm infants: an external validation study.

P E van Beek1, F Groenendaal2, W Onland3

  • 1Department of Neonatology, Máxima Medical Centre, Veldhoven, The Netherlands.

BJOG : an International Journal of Obstetrics and Gynaecology
|November 15, 2021
PubMed
Summary

A validated prognostic model accurately predicts survival in very preterm infants. This high-quality model demonstrated good external validity in a nationwide cohort, supporting its potential clinical use in neonatal intensive care units.

Keywords:
External validationmortalityprediction modelvery preterm infants

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Area of Science:

  • Neonatal Medicine
  • Clinical Epidemiology
  • Biostatistics

Background:

  • A high-quality prognostic model for predicting survival in very preterm infants was previously developed.
  • This model requires external validation to assess its generalizability and reliability.

Purpose of the Study:

  • To perform temporal and geographical validation of a prognostic model for predicting survival in very preterm infants.
  • To assess the model's performance in an independent, population-based cohort.

Main Methods:

  • External validation study using a population-based cohort of infants born between 23 and 32 weeks of gestation.
  • Model performance evaluated using calibration (calibration-in-the-large, calibration slope) and discrimination (c statistic).
  • Model was applied to multiple validation sets, including singletons and multiples, with potential updates.

Main Results:

  • The model demonstrated good external validity with strong discrimination (c statistic 0.82) and calibration.
  • Survival rate in the cohort was 92.9% (5659 out of 6092 infants).
  • The model performed well in singleton populations and required a minor update for multiples.

Conclusions:

  • A high-quality prognostic model for very preterm infant survival is externally valid in an independent, nationwide cohort.
  • The model's accurate performance supports its potential implementation in neonatal intensive care unit clinical practice.
  • Further impact assessment is recommended before widespread clinical adoption.