TY - JOUR
T1 - Retrospective validation study of miniPIERS prediction model in Zanzibar
AU - van der Meij, Elleke
AU - Herklots, Tanneke
AU - Yussuf, Suhaila
AU - Meguid, Tarek
AU - Franx, Arie
AU - Payne, Beth A.
AU - Jacod, Benoit
N1 - Publisher Copyright:
© 2020 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics
PY - 2021/5
Y1 - 2021/5
N2 - Objective: To perform a retrospective external validation of miniPIERS in Zanzibar's referral hospital. Methods: From February to December 2017, data were collected retrospectively on all cases of hypertensive disorders of pregnancy (HDP) admitted to Mnazi Mmoja Hospital, Zanzibar, Tanzania. The primary outcome was the predictive performance of miniPIERS by examining measures of discrimination, calibration, and stratification accuracy. The secondary outcome was the applicability of miniPIERS within the referral hospital setting. Results: During this period, 2218 of 13 395 (21%) patients were identified with HDP, of whom 594 met the inclusion criteria. Sixty per cent of patients with adverse outcomes were excluded because they had experienced one of the adverse outcomes before admission. The discriminative ability of miniPIERS was inaccurate. It was not likely to aid risk stratification because of low sensitivity and low positive predictive value. The model showed fair discrimination in HDP before 34 weeks of gestation (area under the receiver operating characteristics curve 0.72, 95% confidence interval 0.63–0.82). Conclusions: The benefit of miniPIERS appeared to be limited, although clinical conditions make any validation challenging. Its application for risk stratification in preterm pregnancies should be further investigated.
AB - Objective: To perform a retrospective external validation of miniPIERS in Zanzibar's referral hospital. Methods: From February to December 2017, data were collected retrospectively on all cases of hypertensive disorders of pregnancy (HDP) admitted to Mnazi Mmoja Hospital, Zanzibar, Tanzania. The primary outcome was the predictive performance of miniPIERS by examining measures of discrimination, calibration, and stratification accuracy. The secondary outcome was the applicability of miniPIERS within the referral hospital setting. Results: During this period, 2218 of 13 395 (21%) patients were identified with HDP, of whom 594 met the inclusion criteria. Sixty per cent of patients with adverse outcomes were excluded because they had experienced one of the adverse outcomes before admission. The discriminative ability of miniPIERS was inaccurate. It was not likely to aid risk stratification because of low sensitivity and low positive predictive value. The model showed fair discrimination in HDP before 34 weeks of gestation (area under the receiver operating characteristics curve 0.72, 95% confidence interval 0.63–0.82). Conclusions: The benefit of miniPIERS appeared to be limited, although clinical conditions make any validation challenging. Its application for risk stratification in preterm pregnancies should be further investigated.
UR - http://www.scopus.com/inward/record.url?scp=85097961641&partnerID=8YFLogxK
U2 - 10.1002/ijgo.13493
DO - 10.1002/ijgo.13493
M3 - Article
C2 - 33222177
AN - SCOPUS:85097961641
VL - 153
SP - 300
EP - 306
JO - International Journal of Gynecology and Obstetrics
JF - International Journal of Gynecology and Obstetrics
SN - 0020-7292
IS - 2
ER -