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Temporal validation...
Temporal validation and updating of a prediction model for the diagnosis of gestational diabetes mellitus
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- Cooray, Shamil D. (författare)
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, VIC, Clayton, Australia; Diabetes and Endocrinology Units, Monash Health, VIC, Clayton, Australia
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- De Silva Ranakombu, Kushan Kumara (författare)
- Umeå universitet,Institutionen för strålningsvetenskaper,Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, VIC, Clayton, Australia
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- Enticott, Joanne C. (författare)
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, VIC, Clayton, Australia
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- Dawadi, Shrinkhala (författare)
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, VIC, Clayton, Australia
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- Boyle, Jacqueline A. (författare)
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, VIC, Clayton, Australia; Department of Obstetrics and Gynaecology, Monash University, VIC, Clayton, Australia; Eastern Health Clinical School, Monash University, VIC, Box Hill, Australia
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- Soldatos, Georgia (författare)
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, VIC, Clayton, Australia; Diabetes and Endocrinology Units, Monash Health, VIC, Clayton, Australia
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- Paul, Eldho (författare)
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, VIC, Clayton, Australia
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- Versace, Vincent L. (författare)
- Deakin Rural Health, School of Medicine, Deakin University, VIC, Warrnambool, Australia
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- Teede, Helena J. (författare)
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, VIC, Clayton, Australia; Diabetes and Endocrinology Units, Monash Health, VIC, Clayton, Australia
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(creator_code:org_t)
- Elsevier, 2023
- 2023
- Engelska.
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Ingår i: Journal of Clinical Epidemiology. - : Elsevier. - 0895-4356 .- 1878-5921. ; 164, s. 54-64
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Objective: The original Monash gestational diabetes mellitus (GDM) risk prediction in early pregnancy model is internationally externally validated and clinically implemented. We temporally validate and update this model in a contemporary population with a universal screening context and revised diagnostic criteria and ethnicity categories, thereby improving model performance and generalizability.Study Design and Setting: The updating dataset comprised of routinely collected health data for singleton pregnancies delivered in Melbourne, Australia from 2016 to 2018. Model predictors included age, body mass index, ethnicity, diabetes family history, GDM history, and poor obstetric outcome history. Model updating methods were recalibration-in-the-large (Model A), intercept and slope re-estimation (Model B), and coefficient revision using logistic regression (Model C1, original ethnicity categories; Model C2, revised ethnicity categories). Analysis included 10-fold cross-validation, assessment of performance measures (c-statistic, calibration-in-the-large, calibration slope, and expected-observed ratio), and a closed-loop testing procedure to compare models' log-likelihood and akaike information criterion scores.Results: In 26,474 singleton pregnancies (4,756, 18% with GDM), the original model demonstrated reasonable temporal validation (c-statistic = 0.698) but suboptimal calibration (expected-observed ratio = 0.485). Updated model C2 was preferred, with a high c-statistic (0.732) and significantly better performance in closed testing.Conclusion: We demonstrated updating methods to sustain predictive performance in a contemporary population, highlighting the value and versatility of prediction models for guiding risk-stratified GDM care.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)
Nyckelord
- Clinical prediction model
- External temporal validation
- Gestational diabetes mellitus
- Maternal health
- Model updating
- Pregnancy
- Risk prediction modeling
- Risk stratification
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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