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对于胎儿宏观体的多变量预测模型和对于妊娠年龄的大:系统性审查
Lauren Ewington1,2, Naomi Black1,2, Charlotte Leeson1,2
1Division of Biomedical Sciences, University of Warwick, Coventry, UK.
概括
目前没有针对妊娠年龄大 (LGA) 或宏观体的预测模型为临床使用准备好. 需要进一步的研究来开发和验证这些妊娠并发症的可靠预测工具.
科学领域:
- 围产儿医学 围产儿医学
- 生物统计学 生物统计学
- 临床流行病学 临床流行病学
背景情况:
- 准确识别大对妊娠年龄 (LGA) 和宏观胎儿对于有效的怀孕管理和咨询至关重要.
- 现有的预测模型需要严格评估临床适用性.
研究的目的:
- 系统地审查和评估LGA和宏观的多变量预测模型.
- 评估已识别的模型的性能,质量和临床适用性.
主要方法:
- 在 MEDLINE,EMBASE 和 Cochrane 图书馆进行系统的文献搜索,截至 2022 年 6 月.
- 包括观察和实验研究开发或验证多变量预测模型.
- 对模型性能 (歧视,校准),报告质量 (TRIPOD),偏差风险和适用性 (PROBAST) 的评估.
主要成果:
- 包含了58项研究,开发了111个LGA/macrosomia的多变量模型.
- 模型歧视差异很大 (AUROC 0.56-0.96);校准报告只有19%.
- 只有8.6%的研究具有低偏差风险,很少有模型经过外部验证.
结论:
- 目前没有多变量预测模型对宏观症或LGA满足临床实施的标准.
- 在模型验证,报告质量和偏见风险评估方面存在重大差距.
- 在临床采用胎儿生长异常预测模型之前,需要进一步开发和严格验证.
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