External validation of prognostic models predicting pre-eclampsia: individual participant data meta-analysis
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RESEARCH ARTICLE
Open Access
External validation of prognostic models predicting pre-eclampsia: individual participant data meta-analysis Kym I. E. Snell1*†, John Allotey2,3†, Melanie Smuk3, Richard Hooper3, Claire Chan3, Asif Ahmed4, Lucy C. Chappell5, Peter Von Dadelszen5, Marcus Green6, Louise Kenny7, Asma Khalil8, Khalid S. Khan2,3, Ben W. Mol9, Jenny Myers10, Lucilla Poston5, Basky Thilaganathan8, Anne C. Staff11, Gordon C. S. Smith12, Wessel Ganzevoort13, Hannele Laivuori14,15,16, Anthony O. Odibo17, Javier Arenas Ramírez18, John Kingdom19, George Daskalakis20, Diane Farrar21, Ahmet A. Baschat22, Paul T. Seed5, Federico Prefumo23, Fabricio da Silva Costa24, Henk Groen25, Francois Audibert26, Jacques Masse27, Ragnhild B. Skråstad28,29, Kjell Å. Salvesen30,31, Camilla Haavaldsen32, Chie Nagata33, Alice R. Rumbold34, Seppo Heinonen35, Lisa M. Askie36, Luc J. M. Smits37, Christina A. Vinter38, Per Magnus39, Kajantie Eero40,41, Pia M. Villa35, Anne K. Jenum42, Louise B. Andersen43,44, Jane E. Norman45, Akihide Ohkuchi46, Anne Eskild32,47, Sohinee Bhattacharya48, Fionnuala M. McAuliffe49, Alberto Galindo50, Ignacio Herraiz50, Lionel Carbillon51, Kerstin Klipstein-Grobusch52, Seon Ae Yeo53, Joyce L. Browne52, Karel G. M. Moons52,54, Richard D. Riley1, Shakila Thangaratinam55 and for the IPPIC Collaborative Network
Abstract Background: Pre-eclampsia is a leading cause of maternal and perinatal mortality and morbidity. Early identification of women at risk during pregnancy is required to plan management. Although there are many published prediction models for pre-eclampsia, few have been validated in external data. Our objective was to externally validate published prediction models for pre-eclampsia using individual participant data (IPD) from UK studies, to evaluate whether any of the models can accurately predict the condition when used within the UK healthcare setting. Methods: IPD from 11 UK cohort studies (217,415 pregnant women) within the International Prediction of Pregnancy Complications (IPPIC) pre-eclampsia network contributed to external validation of published prediction models, identified by systematic review. Cohorts that measured all predictor variables in at least one of the identified models and reported pre-eclampsia as an outcome were included for validation. We reported the model predictive performance as discrimination (C-statistic), calibration (calibration plots, calibration slope, calibration-in-the-large), and net benefit. Performance measures were estimated separately in each available study and then, where possible, combined across studies in a random-effects meta-analysis. (Continued on next page)
* Correspondence: [email protected] † Kym IE Snell and John Allotey are joint first authors (both contributed equally). 1 Centre for Prognosis Research, School of Primary, Community and Social Care, Keele University, Keele, UK Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attributio
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