Comparing very low birth weight versus very low gestation cohort methods for outcome analysis of high risk preterm infants
Abstract Background Compared to very low gestational age (<32 weeks, VLGA) cohorts, very low birth weight (<1500 g; VLBW) cohorts are more prone to selection bias toward small-for-gestational age (SGA) infants, which may impact upon the validity of data for benchmarking purposes. Method Data f...
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| Format: | Article |
| Language: | English |
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BMC
2017-07-01
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| Series: | BMC Pediatrics |
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| Online Access: | http://link.springer.com/article/10.1186/s12887-017-0921-x |
| _version_ | 1819139085873184768 |
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| author | Louise IM Koller-Smith Prakesh S. Shah Xiang Y. Ye Gunnar Sjörs Yueping A. Wang Sharon S. W. Chow Brian A. Darlow Shoo K. Lee Stellan Håkanson Kei Lui on behalf of the Australian and New Zealand Neonatal Network Canadian Neonatal Network Swedish Neonatal Quality Register |
| author_facet | Louise IM Koller-Smith Prakesh S. Shah Xiang Y. Ye Gunnar Sjörs Yueping A. Wang Sharon S. W. Chow Brian A. Darlow Shoo K. Lee Stellan Håkanson Kei Lui on behalf of the Australian and New Zealand Neonatal Network Canadian Neonatal Network Swedish Neonatal Quality Register |
| author_sort | Louise IM Koller-Smith |
| collection | DOAJ |
| description | Abstract Background Compared to very low gestational age (<32 weeks, VLGA) cohorts, very low birth weight (<1500 g; VLBW) cohorts are more prone to selection bias toward small-for-gestational age (SGA) infants, which may impact upon the validity of data for benchmarking purposes. Method Data from all VLGA or VLBW infants admitted in the 3 Networks between 2008 and 2011 were used. Two-thirds of each network cohort was randomly selected to develop prediction models for mortality and composite adverse outcome (CAO: mortality or cerebral injuries, chronic lung disease, severe retinopathy or necrotizing enterocolitis) and the remaining for internal validation. Areas under the ROC curves (AUC) of the models were compared. Results VLBW cohort (24,335 infants) had twice more SGA infants (20.4% vs. 9.3%) than the VLGA cohort (29,180 infants) and had a higher rate of CAO (36.5% vs. 32.6%). The two models had equal prediction power for mortality and CAO (AUC 0.83), and similarly for all other cross-cohort validations (AUC 0.81–0.85). Neither model performed well for the extremes of birth weight for gestation (<1500 g and ≥32 weeks, AUC 0.50–0.65; ≥1500 g and <32 weeks, AUC 0.60–0.62). Conclusion There was no difference in prediction power for adverse outcome between cohorting VLGA or VLBW despite substantial bias in SGA population. Either cohorting practises are suitable for international benchmarking. |
| first_indexed | 2024-12-22T11:17:04Z |
| format | Article |
| id | doaj.art-d86efc51162b4bc7b6f555711321fa42 |
| institution | Directory Open Access Journal |
| issn | 1471-2431 |
| language | English |
| last_indexed | 2024-12-22T11:17:04Z |
| publishDate | 2017-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pediatrics |
| spelling | doaj.art-d86efc51162b4bc7b6f555711321fa422022-12-21T18:27:58ZengBMCBMC Pediatrics1471-24312017-07-0117111010.1186/s12887-017-0921-xComparing very low birth weight versus very low gestation cohort methods for outcome analysis of high risk preterm infantsLouise IM Koller-Smith0Prakesh S. Shah1Xiang Y. Ye2Gunnar Sjörs3Yueping A. Wang4Sharon S. W. Chow5Brian A. Darlow6Shoo K. Lee7Stellan Håkanson8Kei Lui9on behalf of the Australian and New Zealand Neonatal NetworkCanadian Neonatal NetworkSwedish Neonatal Quality RegisterFaculty of Health Science, University of Technology SydneyDepartment of Pediatrics, Mount Sinai Hospital and University of TorontoMaternal Infant Care Research Centre, Mount Sinai HospitalUppsala UniversityFaculty of Health Science, University of Technology SydneyFaculty of Health Science, University of Technology SydneyDepartment of Paediatrics, University of OtagoDepartment of Pediatrics, Mount Sinai Hospital and University of TorontoUmeå University HospitalFaculty of Health Science, University of Technology SydneyAbstract Background Compared to very low gestational age (<32 weeks, VLGA) cohorts, very low birth weight (<1500 g; VLBW) cohorts are more prone to selection bias toward small-for-gestational age (SGA) infants, which may impact upon the validity of data for benchmarking purposes. Method Data from all VLGA or VLBW infants admitted in the 3 Networks between 2008 and 2011 were used. Two-thirds of each network cohort was randomly selected to develop prediction models for mortality and composite adverse outcome (CAO: mortality or cerebral injuries, chronic lung disease, severe retinopathy or necrotizing enterocolitis) and the remaining for internal validation. Areas under the ROC curves (AUC) of the models were compared. Results VLBW cohort (24,335 infants) had twice more SGA infants (20.4% vs. 9.3%) than the VLGA cohort (29,180 infants) and had a higher rate of CAO (36.5% vs. 32.6%). The two models had equal prediction power for mortality and CAO (AUC 0.83), and similarly for all other cross-cohort validations (AUC 0.81–0.85). Neither model performed well for the extremes of birth weight for gestation (<1500 g and ≥32 weeks, AUC 0.50–0.65; ≥1500 g and <32 weeks, AUC 0.60–0.62). Conclusion There was no difference in prediction power for adverse outcome between cohorting VLGA or VLBW despite substantial bias in SGA population. Either cohorting practises are suitable for international benchmarking.http://link.springer.com/article/10.1186/s12887-017-0921-xOutcomeIntensive careNeonatalInfantPrematureVery low birth weight |
| spellingShingle | Louise IM Koller-Smith Prakesh S. Shah Xiang Y. Ye Gunnar Sjörs Yueping A. Wang Sharon S. W. Chow Brian A. Darlow Shoo K. Lee Stellan Håkanson Kei Lui on behalf of the Australian and New Zealand Neonatal Network Canadian Neonatal Network Swedish Neonatal Quality Register Comparing very low birth weight versus very low gestation cohort methods for outcome analysis of high risk preterm infants BMC Pediatrics Outcome Intensive care Neonatal Infant Premature Very low birth weight |
| title | Comparing very low birth weight versus very low gestation cohort methods for outcome analysis of high risk preterm infants |
| title_full | Comparing very low birth weight versus very low gestation cohort methods for outcome analysis of high risk preterm infants |
| title_fullStr | Comparing very low birth weight versus very low gestation cohort methods for outcome analysis of high risk preterm infants |
| title_full_unstemmed | Comparing very low birth weight versus very low gestation cohort methods for outcome analysis of high risk preterm infants |
| title_short | Comparing very low birth weight versus very low gestation cohort methods for outcome analysis of high risk preterm infants |
| title_sort | comparing very low birth weight versus very low gestation cohort methods for outcome analysis of high risk preterm infants |
| topic | Outcome Intensive care Neonatal Infant Premature Very low birth weight |
| url | http://link.springer.com/article/10.1186/s12887-017-0921-x |
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