External validation of prognostic models predicting pre-eclampsia: individual participant data meta-analysis

Snell, Kym I. E.; Allotey, John; Smuk, Melanie; Hooper, Richard; Chan, Claire; Ahmed, Asif; Chappell, Lucy C.; Von Dadelszen, Peter; Green, Marcus; Kenny, Louise; Khalil, Asma; Khan, Khalid S.; Mol, Ben W.; Myers, Jenny; Poston, Lucilla; Thilaganathan, Basky; Staff, Anne C.; Smith, Gordon C. S.; Ganzevoort, Wessel; Laivuori, Hannele; Odibo, Anthony O.; Arenas Ramírez, Javier; Kingdom, John; Daskalakis, George; Farrar, Diane; Baschat, Ahmet A.; Seed, Paul T.; Prefumo, Federico; da Silva Costa, Fabricio; Groen, Henk; Audibert, Francois; Masse, Jacques; Skråstad, Ragnhild B.; Salvesen, Kjell Å.; Haavaldsen, Camilla; Nagata, Chie; Rumbold, Alice R.; Heinonen, Seppo; Askie, Lisa M.; Smits, Luc J. M.; Vinter, Christina A.; Magnus, Per; Eero, Kajantie; Villa, Pia M.; Jenum, Anne K.; Andersen, Louise B.; Norman, Jane E.; Ohkuchi, Akihide; Eskild, Anne; Bhattacharya, Sohinee; McAuliffe, Fionnuala M.; Galindo, Alberto; Herraiz, Ignacio; Carbillon, Lionel; Klipstein-Grobusch, Kerstin; Yeo, Seon Ae; Browne, Joyce L.; Moons, Karel G. M.; Riley, Richard D.; Thangaratinam, Shakila

doi:10.1186/s12916-020-01766-9

Table 2 Summary estimates of predictive performance for each model across validation cohorts

From: External validation of prognostic models predicting pre-eclampsia: individual participant data meta-analysis

Model no.	Type of predictors	Author (year)	No. of validation cohorts	Total no. of women	Total events	Summary estimate of performance statistic (95% CI), measures of heterogeneity (I², τ²)
Model no.	Type of predictors	Author (year)	No. of validation cohorts	Total no. of women	Total events	C-statistic⁺	Calibration slope	Calibration-in-the-large
Any-onset pre-eclampsia
*Trimester 1 models*
1	Clinical	Plasencia 2007a	3	3257	102	0.69 (0.53, 0.81) I² = 1%, τ² = 0.001	0.69 (− 0.03, 1.41) I² = 45%, τ² = 0.035	0.14 (− 1.47, 1.76) I² = 91%, τ² = 0.380
2		Poon 2008	3	3257	102	0.69 (0.53, 0.81) I² = 3%, τ² = 0.002	0.72 (− 0.03, 1.46) I² = 45%, τ² = 0.037	0.002 (− 1.65, 1.66) I² = 92%, τ² = 0.402
3		Wright 2015a	3	1916	76	0.62 (0.48, 0.75) I² = 0%, τ² = 0	0.64 (− 0.18, 1.47) I² = 0%, τ² = 0	0.95 (− 1.13, 3.03) I² = 93%, τ² = 0.640
4	Clinical and biochemical markers	Baschat 2014a	2	5257	287	0.71 (0.47, 0.87) I² = 0%, τ² = 0	1.24 (0.00, 2.48) I² = 0%, τ² = 0	− 0.43 (− 14.4, 13.55) I² = 98%, τ² = 2.382
5		Goetzinger 2010	3	6811	343	0.66 (0.30, 0.90) I² = 93%, τ² = 0.315	1.124 (− 0.60, 2.84) I² = 76%, τ² = 0.356	− 0.97 (− 3.04, 1.11) I² = 97%, τ² = 0.667
6		Odibo 2011a	3	59,892	1774	0.72 (0.51, 0.86) I² = 90%, τ² = 0.101	1.16 (0.24, 2.08) I² = 93%, τ² = 0.104	− 0.79 (− 2.62, 1.04) I² = 99%, τ² = 0.511
7	Clinical and ultrasound markers	Odibo 2011b	1	1145	28	0.53 (0.39, 0.66)	0.28 (− 0.64, 1.20)	− 0.52 (− 0.91, − 0.13)
*Trimester 2 models*
8	Clinical and ultrasound markers	Yu 2005a	1	4212	273	0.61 (0.57 to 0.65)	0.08 (0.01 to 0.14)	Not estimable
Early-onset pre-eclampsia
*Trimester 1 models*
9	Clinical	Baschat 2014b	5	22,781	204	0.68 (0.62, 0.73) I² = 0%, τ² = 0	2.04 (0.56, 3.52) I² = 69%, τ² = 0.692	− 0.10 (− 1.70 to 1.49) I² = 97%, τ² = 1.535
10		Crovetto 2015a	3^#	6424	21	0.58 (0.21, 0.88) I² = 69%, τ² = 0.288	0.64 (− 4.01, 5.29) I² = 81%, τ² = 0.217	− 0.58 (− 4.97, 3.81) I² = 95%, τ² = 2.925
11		Kuc 2013a	6	212,038	1449	0.66 (0.61, 0.71) I² = 32%, τ² = 0.011	0.42 (0.29, 0.55) I² = 33%, τ² = 0.004	− 4.33 (− 5.41, − 3.25) I² = 99%, τ² = 0.946
12		Plasencia 2007b	4^#	6740	27	0.49 (0.43, 0.55) I² = 38%, τ² = 0.005	0.51 (− 2.05, 3.08) I² = 0%, τ² = 0	0.47 (− 0.80, 1.74) I² = 74%, τ² = 0.452
13		Poon 2010a	3	6424	21	0.64 (0.31, 0.87) I² = 34%, τ² = 0.105	0.99 (0.02, 1.96) I² = 0%, τ² = 0	− 1.09 (− 4.89, 2.70) I² = 93%, τ² = 2.175
14		Scazzocchio 2013a	3	6424	21	0.74 (0.37, 0.93) I² = 14%, τ² = 0.057	0.75 (0.14, 1.36) I² = 0%, τ² = 0	− 0.70 (− 3.89, 2.49) I² = 90%, τ² = 1.481
15		Wright 2015b	2	1332	9	0.74 (0.04, 1.00) I² = 0%, τ² = 0	0.92 (− 4.38, 6.22) I² = 0%, τ² = 0	0.28 (− 14.34, 14.90) I² = 90%, τ² = 2.395
16	Clinical and biochemical markers	Poon 2009a	1	4212	10	0.74 (0.51, 0.89)	0.45 (0.21, 0.69)	− 2.67 (− 3.35, − 1.99)
*Trimester 2 models*
17	Clinical and ultrasound markers	Yu 2005b	1	4212	10	0.91 (0.83, 0.95)	0.56 (0.29, 0.82)	2.47 (1.72, 3.23)
Late-onset pre-eclampsia
*Trimester 1 models*
18	Clinical	Crovetto 2015b	5	7785	384	0.63 (0.46, 0.78) I² = 87%, τ² = 0.264	0.56 (− 0.01 to 1.13) I² = 92%, τ² = 0.179	− 0.05 (− 1.65, 1.55) I² = 98%, τ² = 1.615
19		Kuc 2013b	8	213,532	5716	0.62 (0.57, 0.67) I² = 87%, τ² = 0.025	0.66 (0.50, 0.82) I² = 60%, τ² = 0.007	− 1.91 (− 2.24, − 1.59) I² = 98%, τ² = 0.124
20		Plasencia 2007c	3	3257	90	0.67 (0.54, 0.78) I² = 0%, τ² = 0	0.61 (0.04, 1.18) I² = 14%, τ² = 0.008	0.20 (− 1.11, 1.52) I² = 85%, τ² = 0.234
21		Poon 2010b	3	3257	90	0.65 (0.48, 0.79) I² = 25%, τ² = 0.020	0.57 (0.08, 1.05) I² = 0%, τ² = 0	0.12 (− 1.59, 1.84) I² = 91%, τ² = 0.430
22		Scazzocchio 2013b	1	658	26	0.60 (0.48, 0.71)	0.56 (− 0.17, 1.29)	0.52 (0.13, 0.92)
23	Clinical and biochemical markers	Poon 2009b	1	1045	13	0.68 (0.55, 0.79)	0.80 (0.26, 1.34)	− 0.35 (− 0.90, 0.21)
*Trimester 2 models*
24	Clinical and ultrasound markers	Yu 2005c	1	4212	263	0.61 (0.57, 0.64)	0.08 (0.05, 0.15)	Not estimable

# Number of validation cohorts is 2 for the calibration slope as it could not be estimated reliably in SCOPE (for models 10 and 12) or POP (for model 12), and was therefore excluded from the meta-analysis. + The C-statistic was pooled on the logit scale, therefore I² is for logit(C-statistic).

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