Loading…
A clinical prediction rule for the severity of congenital diaphragmatic hernias in newborns
Congenital diaphragmatic hernia (CDH) is a condition with a highly variable outcome. Some infants have a relatively mild disease process, whereas others have significant pulmonary hypoplasia and hypertension. Identifying high-risk infants postnatally may allow for targeted therapy. Data were obtaine...
Saved in:
| Published in: | Pediatrics (Evanston) 2014-08, Vol.134 (2), p.e413-e419 |
|---|---|
| Main Authors: | , , , , |
| Format: | Article |
| Language: | English |
| Subjects: | |
| Citations: | Items that this one cites Items that cite this one |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| cited_by | cdi_FETCH-LOGICAL-c427t-69ad65e3e97ababc56253a2901b7d89143cd2f252fa1f66bda7a6219bb53b0383 |
|---|---|
| cites | cdi_FETCH-LOGICAL-c427t-69ad65e3e97ababc56253a2901b7d89143cd2f252fa1f66bda7a6219bb53b0383 |
| container_end_page | e419 |
| container_issue | 2 |
| container_start_page | e413 |
| container_title | Pediatrics (Evanston) |
| container_volume | 134 |
| creator | Brindle, Mary Elizabeth Cook, Earl Francis Tibboel, Dick Lally, Pamela A Lally, Kevin P |
| description | Congenital diaphragmatic hernia (CDH) is a condition with a highly variable outcome. Some infants have a relatively mild disease process, whereas others have significant pulmonary hypoplasia and hypertension. Identifying high-risk infants postnatally may allow for targeted therapy.
Data were obtained on 2202 infants from the Congenital Diaphragmatic Hernia Study Group database from January 2007 to October 2011. Using binary baseline predictors generated from birth weight, 5-minute Apgar score, congenital heart anomalies, and chromosome anomalies, as well as echocardiographic evidence of pulmonary hypertension, a clinical prediction rule was developed on a randomly selected subset of the data by using a backward selection algorithm. An integer-based clinical prediction rule was created. The performance of the model was validated by using the remaining data in terms of calibration and discrimination.
The final model included the following predictors: very low birth weight, absent or low 5-minute Apgar score, presence of chromosomal or major cardiac anomaly, and suprasystemic pulmonary hypertension. This model discriminated between a population at high risk of death (∼50%) intermediate risk (∼20%), or low risk ( |
| doi_str_mv | 10.1542/peds.2013-3367 |
| format | article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_1551019556</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A377478211</galeid><sourcerecordid>A377478211</sourcerecordid><originalsourceid>FETCH-LOGICAL-c427t-69ad65e3e97ababc56253a2901b7d89143cd2f252fa1f66bda7a6219bb53b0383</originalsourceid><addsrcrecordid>eNpdkT1v2zAQQImiQeN8rB0LAl2yyOGHKEqjYbRJgABZ0qkDQVInmwFNqiSVNP8-Epxm6HTLu8M7PIS-UrKmombXI_R5zQjlFeeN_IRWlHRtVTMpPqMVIZxWNSHiFJ3l_EQIqYVkX9ApE4QxWYsV-r3B1rvgrPZ4TNA7W1wMOE0e8BATLnvAGZ4hufKK44BtDDsIrsx47_S4T3p30MVZvIcUnM7YBRzgxcQU8gU6GbTPcPk-z9Gvnz8et7fV_cPN3XZzX9nZs1RNp_tGAIdOaqONFQ0TXLOOUCP7tqM1tz0bmGCDpkPTmF5L3TDaGSO4Ibzl5-jqeHdM8c8EuaiDyxa81wHilBUVghLaCdHM6Pf_0Kc4pTDbLRSjtRDtcrA6UjvtQbkwP13gb7HRe9iBmuW3D2rDpaxlyyid-fWRtynmnGBQY3IHnV4VJWrJpJZMasmklkzzwrd3jckcoP_A_3XhbzesjSw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1552145588</pqid></control><display><type>article</type><title>A clinical prediction rule for the severity of congenital diaphragmatic hernias in newborns</title><source>EZB Free E-Journals</source><creator>Brindle, Mary Elizabeth ; Cook, Earl Francis ; Tibboel, Dick ; Lally, Pamela A ; Lally, Kevin P</creator><creatorcontrib>Brindle, Mary Elizabeth ; Cook, Earl Francis ; Tibboel, Dick ; Lally, Pamela A ; Lally, Kevin P ; Congenital Diaphragmatic Hernia Study Group</creatorcontrib><description>Congenital diaphragmatic hernia (CDH) is a condition with a highly variable outcome. Some infants have a relatively mild disease process, whereas others have significant pulmonary hypoplasia and hypertension. Identifying high-risk infants postnatally may allow for targeted therapy.
Data were obtained on 2202 infants from the Congenital Diaphragmatic Hernia Study Group database from January 2007 to October 2011. Using binary baseline predictors generated from birth weight, 5-minute Apgar score, congenital heart anomalies, and chromosome anomalies, as well as echocardiographic evidence of pulmonary hypertension, a clinical prediction rule was developed on a randomly selected subset of the data by using a backward selection algorithm. An integer-based clinical prediction rule was created. The performance of the model was validated by using the remaining data in terms of calibration and discrimination.
The final model included the following predictors: very low birth weight, absent or low 5-minute Apgar score, presence of chromosomal or major cardiac anomaly, and suprasystemic pulmonary hypertension. This model discriminated between a population at high risk of death (∼50%) intermediate risk (∼20%), or low risk (<10%). The model performed well, with a C statistic of 0.806 in the derivation set and 0.769 in the validation set and good calibration (Hosmer-Lemeshow test, P = .2).
A simple, generalizable scoring system was developed for CDH that can be calculated rapidly at the bedside. Using this model, intermediate- and high-risk infants could be selected for transfer to high-volume centers while infants at highest risk could be considered for advanced medical therapies.</description><identifier>ISSN: 0031-4005</identifier><identifier>EISSN: 1098-4275</identifier><identifier>DOI: 10.1542/peds.2013-3367</identifier><identifier>PMID: 25022745</identifier><identifier>CODEN: PEDIAU</identifier><language>eng</language><publisher>United States: American Academy of Pediatrics</publisher><subject>Analysis ; Apgar Score ; Babies ; Birth weight ; Comorbidity ; Complications and side effects ; Decision Support Techniques ; Diaphragm ; Diaphragmatic hernia ; Female ; Health aspects ; Heart Defects, Congenital - epidemiology ; Hernia ; Hernia, Diaphragmatic - epidemiology ; Hernia, Diaphragmatic - mortality ; Hernia, Diaphragmatic - therapy ; Hernias ; Hernias, Diaphragmatic, Congenital ; Humans ; Hypertension ; Hypertension, Pulmonary - diagnostic imaging ; Hypertension, Pulmonary - epidemiology ; Infant, Newborn ; Infants ; Male ; Outcome and process assessment (Health Care) ; Outcome and process assessment (Medical care) ; Pediatrics ; Pulmonary hypertension ; Risk Assessment ; Risk factors ; Severity of Illness Index ; Ultrasonography</subject><ispartof>Pediatrics (Evanston), 2014-08, Vol.134 (2), p.e413-e419</ispartof><rights>Copyright © 2014 by the American Academy of Pediatrics.</rights><rights>Copyright American Academy of Pediatrics Aug 2014</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c427t-69ad65e3e97ababc56253a2901b7d89143cd2f252fa1f66bda7a6219bb53b0383</citedby><cites>FETCH-LOGICAL-c427t-69ad65e3e97ababc56253a2901b7d89143cd2f252fa1f66bda7a6219bb53b0383</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,786,790,27957,27958</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25022745$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Brindle, Mary Elizabeth</creatorcontrib><creatorcontrib>Cook, Earl Francis</creatorcontrib><creatorcontrib>Tibboel, Dick</creatorcontrib><creatorcontrib>Lally, Pamela A</creatorcontrib><creatorcontrib>Lally, Kevin P</creatorcontrib><creatorcontrib>Congenital Diaphragmatic Hernia Study Group</creatorcontrib><title>A clinical prediction rule for the severity of congenital diaphragmatic hernias in newborns</title><title>Pediatrics (Evanston)</title><addtitle>Pediatrics</addtitle><description>Congenital diaphragmatic hernia (CDH) is a condition with a highly variable outcome. Some infants have a relatively mild disease process, whereas others have significant pulmonary hypoplasia and hypertension. Identifying high-risk infants postnatally may allow for targeted therapy.
Data were obtained on 2202 infants from the Congenital Diaphragmatic Hernia Study Group database from January 2007 to October 2011. Using binary baseline predictors generated from birth weight, 5-minute Apgar score, congenital heart anomalies, and chromosome anomalies, as well as echocardiographic evidence of pulmonary hypertension, a clinical prediction rule was developed on a randomly selected subset of the data by using a backward selection algorithm. An integer-based clinical prediction rule was created. The performance of the model was validated by using the remaining data in terms of calibration and discrimination.
The final model included the following predictors: very low birth weight, absent or low 5-minute Apgar score, presence of chromosomal or major cardiac anomaly, and suprasystemic pulmonary hypertension. This model discriminated between a population at high risk of death (∼50%) intermediate risk (∼20%), or low risk (<10%). The model performed well, with a C statistic of 0.806 in the derivation set and 0.769 in the validation set and good calibration (Hosmer-Lemeshow test, P = .2).
A simple, generalizable scoring system was developed for CDH that can be calculated rapidly at the bedside. Using this model, intermediate- and high-risk infants could be selected for transfer to high-volume centers while infants at highest risk could be considered for advanced medical therapies.</description><subject>Analysis</subject><subject>Apgar Score</subject><subject>Babies</subject><subject>Birth weight</subject><subject>Comorbidity</subject><subject>Complications and side effects</subject><subject>Decision Support Techniques</subject><subject>Diaphragm</subject><subject>Diaphragmatic hernia</subject><subject>Female</subject><subject>Health aspects</subject><subject>Heart Defects, Congenital - epidemiology</subject><subject>Hernia</subject><subject>Hernia, Diaphragmatic - epidemiology</subject><subject>Hernia, Diaphragmatic - mortality</subject><subject>Hernia, Diaphragmatic - therapy</subject><subject>Hernias</subject><subject>Hernias, Diaphragmatic, Congenital</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Hypertension, Pulmonary - diagnostic imaging</subject><subject>Hypertension, Pulmonary - epidemiology</subject><subject>Infant, Newborn</subject><subject>Infants</subject><subject>Male</subject><subject>Outcome and process assessment (Health Care)</subject><subject>Outcome and process assessment (Medical care)</subject><subject>Pediatrics</subject><subject>Pulmonary hypertension</subject><subject>Risk Assessment</subject><subject>Risk factors</subject><subject>Severity of Illness Index</subject><subject>Ultrasonography</subject><issn>0031-4005</issn><issn>1098-4275</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><recordid>eNpdkT1v2zAQQImiQeN8rB0LAl2yyOGHKEqjYbRJgABZ0qkDQVInmwFNqiSVNP8-Epxm6HTLu8M7PIS-UrKmombXI_R5zQjlFeeN_IRWlHRtVTMpPqMVIZxWNSHiFJ3l_EQIqYVkX9ApE4QxWYsV-r3B1rvgrPZ4TNA7W1wMOE0e8BATLnvAGZ4hufKK44BtDDsIrsx47_S4T3p30MVZvIcUnM7YBRzgxcQU8gU6GbTPcPk-z9Gvnz8et7fV_cPN3XZzX9nZs1RNp_tGAIdOaqONFQ0TXLOOUCP7tqM1tz0bmGCDpkPTmF5L3TDaGSO4Ibzl5-jqeHdM8c8EuaiDyxa81wHilBUVghLaCdHM6Pf_0Kc4pTDbLRSjtRDtcrA6UjvtQbkwP13gb7HRe9iBmuW3D2rDpaxlyyid-fWRtynmnGBQY3IHnV4VJWrJpJZMasmklkzzwrd3jckcoP_A_3XhbzesjSw</recordid><startdate>201408</startdate><enddate>201408</enddate><creator>Brindle, Mary Elizabeth</creator><creator>Cook, Earl Francis</creator><creator>Tibboel, Dick</creator><creator>Lally, Pamela A</creator><creator>Lally, Kevin P</creator><general>American Academy of Pediatrics</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>201408</creationdate><title>A clinical prediction rule for the severity of congenital diaphragmatic hernias in newborns</title><author>Brindle, Mary Elizabeth ; Cook, Earl Francis ; Tibboel, Dick ; Lally, Pamela A ; Lally, Kevin P</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c427t-69ad65e3e97ababc56253a2901b7d89143cd2f252fa1f66bda7a6219bb53b0383</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Analysis</topic><topic>Apgar Score</topic><topic>Babies</topic><topic>Birth weight</topic><topic>Comorbidity</topic><topic>Complications and side effects</topic><topic>Decision Support Techniques</topic><topic>Diaphragm</topic><topic>Diaphragmatic hernia</topic><topic>Female</topic><topic>Health aspects</topic><topic>Heart Defects, Congenital - epidemiology</topic><topic>Hernia</topic><topic>Hernia, Diaphragmatic - epidemiology</topic><topic>Hernia, Diaphragmatic - mortality</topic><topic>Hernia, Diaphragmatic - therapy</topic><topic>Hernias</topic><topic>Hernias, Diaphragmatic, Congenital</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Hypertension, Pulmonary - diagnostic imaging</topic><topic>Hypertension, Pulmonary - epidemiology</topic><topic>Infant, Newborn</topic><topic>Infants</topic><topic>Male</topic><topic>Outcome and process assessment (Health Care)</topic><topic>Outcome and process assessment (Medical care)</topic><topic>Pediatrics</topic><topic>Pulmonary hypertension</topic><topic>Risk Assessment</topic><topic>Risk factors</topic><topic>Severity of Illness Index</topic><topic>Ultrasonography</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Brindle, Mary Elizabeth</creatorcontrib><creatorcontrib>Cook, Earl Francis</creatorcontrib><creatorcontrib>Tibboel, Dick</creatorcontrib><creatorcontrib>Lally, Pamela A</creatorcontrib><creatorcontrib>Lally, Kevin P</creatorcontrib><creatorcontrib>Congenital Diaphragmatic Hernia Study Group</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatrics (Evanston)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Brindle, Mary Elizabeth</au><au>Cook, Earl Francis</au><au>Tibboel, Dick</au><au>Lally, Pamela A</au><au>Lally, Kevin P</au><aucorp>Congenital Diaphragmatic Hernia Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A clinical prediction rule for the severity of congenital diaphragmatic hernias in newborns</atitle><jtitle>Pediatrics (Evanston)</jtitle><addtitle>Pediatrics</addtitle><date>2014-08</date><risdate>2014</risdate><volume>134</volume><issue>2</issue><spage>e413</spage><epage>e419</epage><pages>e413-e419</pages><issn>0031-4005</issn><eissn>1098-4275</eissn><coden>PEDIAU</coden><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>Congenital diaphragmatic hernia (CDH) is a condition with a highly variable outcome. Some infants have a relatively mild disease process, whereas others have significant pulmonary hypoplasia and hypertension. Identifying high-risk infants postnatally may allow for targeted therapy.
Data were obtained on 2202 infants from the Congenital Diaphragmatic Hernia Study Group database from January 2007 to October 2011. Using binary baseline predictors generated from birth weight, 5-minute Apgar score, congenital heart anomalies, and chromosome anomalies, as well as echocardiographic evidence of pulmonary hypertension, a clinical prediction rule was developed on a randomly selected subset of the data by using a backward selection algorithm. An integer-based clinical prediction rule was created. The performance of the model was validated by using the remaining data in terms of calibration and discrimination.
The final model included the following predictors: very low birth weight, absent or low 5-minute Apgar score, presence of chromosomal or major cardiac anomaly, and suprasystemic pulmonary hypertension. This model discriminated between a population at high risk of death (∼50%) intermediate risk (∼20%), or low risk (<10%). The model performed well, with a C statistic of 0.806 in the derivation set and 0.769 in the validation set and good calibration (Hosmer-Lemeshow test, P = .2).
A simple, generalizable scoring system was developed for CDH that can be calculated rapidly at the bedside. Using this model, intermediate- and high-risk infants could be selected for transfer to high-volume centers while infants at highest risk could be considered for advanced medical therapies.</abstract><cop>United States</cop><pub>American Academy of Pediatrics</pub><pmid>25022745</pmid><doi>10.1542/peds.2013-3367</doi></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0031-4005 |
| ispartof | Pediatrics (Evanston), 2014-08, Vol.134 (2), p.e413-e419 |
| issn | 0031-4005 1098-4275 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1551019556 |
| source | EZB Free E-Journals |
| subjects | Analysis Apgar Score Babies Birth weight Comorbidity Complications and side effects Decision Support Techniques Diaphragm Diaphragmatic hernia Female Health aspects Heart Defects, Congenital - epidemiology Hernia Hernia, Diaphragmatic - epidemiology Hernia, Diaphragmatic - mortality Hernia, Diaphragmatic - therapy Hernias Hernias, Diaphragmatic, Congenital Humans Hypertension Hypertension, Pulmonary - diagnostic imaging Hypertension, Pulmonary - epidemiology Infant, Newborn Infants Male Outcome and process assessment (Health Care) Outcome and process assessment (Medical care) Pediatrics Pulmonary hypertension Risk Assessment Risk factors Severity of Illness Index Ultrasonography |
| title | A clinical prediction rule for the severity of congenital diaphragmatic hernias in newborns |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-09-21T03%3A18%3A52IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_proqu&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=A%20clinical%20prediction%20rule%20for%20the%20severity%20of%20congenital%20diaphragmatic%20hernias%20in%20newborns&rft.jtitle=Pediatrics%20(Evanston)&rft.au=Brindle,%20Mary%20Elizabeth&rft.aucorp=Congenital%20Diaphragmatic%20Hernia%20Study%20Group&rft.date=2014-08&rft.volume=134&rft.issue=2&rft.spage=e413&rft.epage=e419&rft.pages=e413-e419&rft.issn=0031-4005&rft.eissn=1098-4275&rft.coden=PEDIAU&rft_id=info:doi/10.1542/peds.2013-3367&rft_dat=%3Cgale_proqu%3EA377478211%3C/gale_proqu%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c427t-69ad65e3e97ababc56253a2901b7d89143cd2f252fa1f66bda7a6219bb53b0383%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=1552145588&rft_id=info:pmid/25022745&rft_galeid=A377478211&rfr_iscdi=true |