External validation of prognostic models to predict risk of gestational diabetes mellitus in one Dutch cohort: prospective multicentre cohort study
Objective To perform an external validation and direct comparison of published prognostic models for early prediction of the risk of gestational diabetes mellitus, including predictors applicable in the first trimester of pregnancy.Design External validation of all published prognostic models in lar...
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| creator | Lamain-de Ruiter, Marije Kwee, Anneke Naaktgeboren, Christiana A de Groot, Inge Evers, Inge M Groenendaal, Floris Hering, Yolanda R Huisjes, Anjoke J M Kirpestein, Cornel Monincx, Wilma M Siljee, Jacqueline E Van ’t Zelfde, Annewil van Oirschot, Charlotte M Vankan-Buitelaar, Simone A Vonk, Mariska A A W Wiegers, Therese A Zwart, Joost J Franx, Arie Moons, Karel G M Koster, Maria P H |
| description | Objective To perform an external validation and direct comparison of published prognostic models for early prediction of the risk of gestational diabetes mellitus, including predictors applicable in the first trimester of pregnancy.Design External validation of all published prognostic models in large scale, prospective, multicentre cohort study.Setting 31 independent midwifery practices and six hospitals in the Netherlands.Participants Women recruited in their first trimester ( |
| doi_str_mv | 10.1136/bmj.i4338 |
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| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1815975997</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1815975997</sourcerecordid><originalsourceid>FETCH-LOGICAL-b378t-fa1e7ef9139144c539f9a1c818ef8e3fdbbedfe89aca7c29d5003b9bdf52f3833</originalsourceid><addsrcrecordid>eNplkc1OxCAUhYnRqNFZ-AKGxJjoYrQMpYA7439i4kbXDYWLMrZlLHSiz-ELS2dGY3QFge-ee889CO2R7IQQWpxWzfTE5ZSKNbRNOCvGRFC6_uu-hUYhTLMsm1AuZME20daEM16Igm-jz6v3CF2rajxXtTMqOt9ib_Gs88-tD9Fp3HgDdcDRp0cwTkfcufA6QM8Q4qIilRunKogQcAN17WIfsEtCLeDLPuoXrP2L7-LZoBtmoKObA276OulDGztY_eMQe_OxizasqgOMVucOerq-ery4Hd8_3NxdnN-Pq2Qkjq0iwMFKQiXJc82otFIRLYgAK4BaU1VgLAiptOJ6Ig3LMlrJylg2sTQtZgcdLXXTUG998lI2Lug0vmrB96EkgjDJmZQ8oQd_0Knvh7WFkpK8yCUTQibqeEnp5DJ0YMtZ5xrVfZQkK4ewyhRWuQgrsfsrxb5qwPyQ39Ek4HAJDDU_3f4LfQGqxqAx</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3146495889</pqid></control><display><type>article</type><title>External validation of prognostic models to predict risk of gestational diabetes mellitus in one Dutch cohort: prospective multicentre cohort study</title><source>Jstor Complete Legacy</source><source>MEDLINE</source><source>BMJ Journals - NESLi2</source><creator>Lamain-de Ruiter, Marije ; Kwee, Anneke ; Naaktgeboren, Christiana A ; de Groot, Inge ; Evers, Inge M ; Groenendaal, Floris ; Hering, Yolanda R ; Huisjes, Anjoke J M ; Kirpestein, Cornel ; Monincx, Wilma M ; Siljee, Jacqueline E ; Van ’t Zelfde, Annewil ; van Oirschot, Charlotte M ; Vankan-Buitelaar, Simone A ; Vonk, Mariska A A W ; Wiegers, Therese A ; Zwart, Joost J ; Franx, Arie ; Moons, Karel G M ; Koster, Maria P H</creator><creatorcontrib>Lamain-de Ruiter, Marije ; Kwee, Anneke ; Naaktgeboren, Christiana A ; de Groot, Inge ; Evers, Inge M ; Groenendaal, Floris ; Hering, Yolanda R ; Huisjes, Anjoke J M ; Kirpestein, Cornel ; Monincx, Wilma M ; Siljee, Jacqueline E ; Van ’t Zelfde, Annewil ; van Oirschot, Charlotte M ; Vankan-Buitelaar, Simone A ; Vonk, Mariska A A W ; Wiegers, Therese A ; Zwart, Joost J ; Franx, Arie ; Moons, Karel G M ; Koster, Maria P H</creatorcontrib><description>Objective To perform an external validation and direct comparison of published prognostic models for early prediction of the risk of gestational diabetes mellitus, including predictors applicable in the first trimester of pregnancy.Design External validation of all published prognostic models in large scale, prospective, multicentre cohort study.Setting 31 independent midwifery practices and six hospitals in the Netherlands.Participants Women recruited in their first trimester (<14 weeks) of pregnancy between December 2012 and January 2014, at their initial prenatal visit. Women with pre-existing diabetes mellitus of any type were excluded. Main outcome measures Discrimination of the prognostic models was assessed by the C statistic, and calibration assessed by calibration plots. Results 3723 women were included for analysis, of whom 181 (4.9%) developed gestational diabetes mellitus in pregnancy. 12 prognostic models for the disorder could be validated in the cohort. C statistics ranged from 0.67 to 0.78. Calibration plots showed that eight of the 12 models were well calibrated. The four models with the highest C statistics included almost all of the following predictors: maternal age, maternal body mass index, history of gestational diabetes mellitus, ethnicity, and family history of diabetes. Prognostic models had a similar performance in a subgroup of nulliparous women only. Decision curve analysis showed that the use of these four models always had a positive net benefit.Conclusions In this external validation study, most of the published prognostic models for gestational diabetes mellitus show acceptable discrimination and calibration. The four models with the highest discriminative abilities in this study cohort, which also perform well in a subgroup of nulliparous women, are easy models to apply in clinical practice and therefore deserve further evaluation regarding their clinical impact.</description><identifier>ISSN: 1756-1833</identifier><identifier>EISSN: 1756-1833</identifier><identifier>DOI: 10.1136/bmj.i4338</identifier><identifier>PMID: 27576867</identifier><language>eng</language><publisher>England: British Medical Journal Publishing Group</publisher><subject>Adult ; Blood pressure ; Body Mass Index ; Calibration ; Cohort analysis ; Diabetes mellitus ; Diabetes Mellitus - genetics ; Diabetes, Gestational - epidemiology ; Diabetes, Gestational - ethnology ; Ethnicity ; Female ; Gestational diabetes ; Glucose ; Humans ; Maternal Age ; Medical prognosis ; Netherlands - epidemiology ; Ovaries ; Parity ; Patients ; Polycystic ovary syndrome ; Predictive Value of Tests ; Pregnancy ; Pregnancy complications ; Pregnancy Trimester, First ; Prospective Studies ; Risk Assessment - methods ; Risk Factors ; Statistical analysis ; Statistics as Topic ; Systematic review ; Validation studies ; Womens health</subject><ispartof>BMJ (Online), 2016-08, Vol.354, p.i4338-i4338</ispartof><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions 2016 BMJ This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/ . Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b378t-fa1e7ef9139144c539f9a1c818ef8e3fdbbedfe89aca7c29d5003b9bdf52f3833</citedby><cites>FETCH-LOGICAL-b378t-fa1e7ef9139144c539f9a1c818ef8e3fdbbedfe89aca7c29d5003b9bdf52f3833</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://bmj.com/content/354/bmj.i4338.full.pdf$$EPDF$$P50$$Gbmj$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://bmj.com/content/354/bmj.i4338.full$$EHTML$$P50$$Gbmj$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3183,27901,27902,55321,77401,77427</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27576867$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lamain-de Ruiter, Marije</creatorcontrib><creatorcontrib>Kwee, Anneke</creatorcontrib><creatorcontrib>Naaktgeboren, Christiana A</creatorcontrib><creatorcontrib>de Groot, Inge</creatorcontrib><creatorcontrib>Evers, Inge M</creatorcontrib><creatorcontrib>Groenendaal, Floris</creatorcontrib><creatorcontrib>Hering, Yolanda R</creatorcontrib><creatorcontrib>Huisjes, Anjoke J M</creatorcontrib><creatorcontrib>Kirpestein, Cornel</creatorcontrib><creatorcontrib>Monincx, Wilma M</creatorcontrib><creatorcontrib>Siljee, Jacqueline E</creatorcontrib><creatorcontrib>Van ’t Zelfde, Annewil</creatorcontrib><creatorcontrib>van Oirschot, Charlotte M</creatorcontrib><creatorcontrib>Vankan-Buitelaar, Simone A</creatorcontrib><creatorcontrib>Vonk, Mariska A A W</creatorcontrib><creatorcontrib>Wiegers, Therese A</creatorcontrib><creatorcontrib>Zwart, Joost J</creatorcontrib><creatorcontrib>Franx, Arie</creatorcontrib><creatorcontrib>Moons, Karel G M</creatorcontrib><creatorcontrib>Koster, Maria P H</creatorcontrib><title>External validation of prognostic models to predict risk of gestational diabetes mellitus in one Dutch cohort: prospective multicentre cohort study</title><title>BMJ (Online)</title><addtitle>BMJ</addtitle><addtitle>BMJ</addtitle><description>Objective To perform an external validation and direct comparison of published prognostic models for early prediction of the risk of gestational diabetes mellitus, including predictors applicable in the first trimester of pregnancy.Design External validation of all published prognostic models in large scale, prospective, multicentre cohort study.Setting 31 independent midwifery practices and six hospitals in the Netherlands.Participants Women recruited in their first trimester (<14 weeks) of pregnancy between December 2012 and January 2014, at their initial prenatal visit. Women with pre-existing diabetes mellitus of any type were excluded. Main outcome measures Discrimination of the prognostic models was assessed by the C statistic, and calibration assessed by calibration plots. Results 3723 women were included for analysis, of whom 181 (4.9%) developed gestational diabetes mellitus in pregnancy. 12 prognostic models for the disorder could be validated in the cohort. C statistics ranged from 0.67 to 0.78. Calibration plots showed that eight of the 12 models were well calibrated. The four models with the highest C statistics included almost all of the following predictors: maternal age, maternal body mass index, history of gestational diabetes mellitus, ethnicity, and family history of diabetes. Prognostic models had a similar performance in a subgroup of nulliparous women only. Decision curve analysis showed that the use of these four models always had a positive net benefit.Conclusions In this external validation study, most of the published prognostic models for gestational diabetes mellitus show acceptable discrimination and calibration. The four models with the highest discriminative abilities in this study cohort, which also perform well in a subgroup of nulliparous women, are easy models to apply in clinical practice and therefore deserve further evaluation regarding their clinical impact.</description><subject>Adult</subject><subject>Blood pressure</subject><subject>Body Mass Index</subject><subject>Calibration</subject><subject>Cohort analysis</subject><subject>Diabetes mellitus</subject><subject>Diabetes Mellitus - genetics</subject><subject>Diabetes, Gestational - epidemiology</subject><subject>Diabetes, Gestational - ethnology</subject><subject>Ethnicity</subject><subject>Female</subject><subject>Gestational diabetes</subject><subject>Glucose</subject><subject>Humans</subject><subject>Maternal Age</subject><subject>Medical prognosis</subject><subject>Netherlands - epidemiology</subject><subject>Ovaries</subject><subject>Parity</subject><subject>Patients</subject><subject>Polycystic ovary syndrome</subject><subject>Predictive Value of Tests</subject><subject>Pregnancy</subject><subject>Pregnancy complications</subject><subject>Pregnancy Trimester, First</subject><subject>Prospective Studies</subject><subject>Risk Assessment - methods</subject><subject>Risk Factors</subject><subject>Statistical analysis</subject><subject>Statistics as Topic</subject><subject>Systematic review</subject><subject>Validation studies</subject><subject>Womens health</subject><issn>1756-1833</issn><issn>1756-1833</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>9YT</sourceid><sourceid>ACMMV</sourceid><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNplkc1OxCAUhYnRqNFZ-AKGxJjoYrQMpYA7439i4kbXDYWLMrZlLHSiz-ELS2dGY3QFge-ee889CO2R7IQQWpxWzfTE5ZSKNbRNOCvGRFC6_uu-hUYhTLMsm1AuZME20daEM16Igm-jz6v3CF2rajxXtTMqOt9ib_Gs88-tD9Fp3HgDdcDRp0cwTkfcufA6QM8Q4qIilRunKogQcAN17WIfsEtCLeDLPuoXrP2L7-LZoBtmoKObA276OulDGztY_eMQe_OxizasqgOMVucOerq-ery4Hd8_3NxdnN-Pq2Qkjq0iwMFKQiXJc82otFIRLYgAK4BaU1VgLAiptOJ6Ig3LMlrJylg2sTQtZgcdLXXTUG998lI2Lug0vmrB96EkgjDJmZQ8oQd_0Knvh7WFkpK8yCUTQibqeEnp5DJ0YMtZ5xrVfZQkK4ewyhRWuQgrsfsrxb5qwPyQ39Ek4HAJDDU_3f4LfQGqxqAx</recordid><startdate>20160830</startdate><enddate>20160830</enddate><creator>Lamain-de Ruiter, Marije</creator><creator>Kwee, Anneke</creator><creator>Naaktgeboren, Christiana A</creator><creator>de Groot, Inge</creator><creator>Evers, Inge M</creator><creator>Groenendaal, Floris</creator><creator>Hering, Yolanda R</creator><creator>Huisjes, Anjoke J M</creator><creator>Kirpestein, Cornel</creator><creator>Monincx, Wilma M</creator><creator>Siljee, Jacqueline E</creator><creator>Van ’t Zelfde, Annewil</creator><creator>van Oirschot, Charlotte M</creator><creator>Vankan-Buitelaar, Simone A</creator><creator>Vonk, Mariska A A W</creator><creator>Wiegers, Therese A</creator><creator>Zwart, Joost J</creator><creator>Franx, Arie</creator><creator>Moons, Karel G M</creator><creator>Koster, Maria P H</creator><general>British Medical Journal Publishing Group</general><general>BMJ Publishing Group LTD</general><scope>9YT</scope><scope>ACMMV</scope><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>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88I</scope><scope>8AF</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ASE</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K6X</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M2O</scope><scope>M2P</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20160830</creationdate><title>External validation of prognostic models to predict risk of gestational diabetes mellitus in one Dutch cohort: prospective multicentre cohort study</title><author>Lamain-de Ruiter, Marije ; Kwee, Anneke ; Naaktgeboren, Christiana A ; de Groot, Inge ; Evers, Inge M ; Groenendaal, Floris ; Hering, Yolanda R ; Huisjes, Anjoke J M ; Kirpestein, Cornel ; Monincx, Wilma M ; Siljee, Jacqueline E ; Van ’t Zelfde, Annewil ; van Oirschot, Charlotte M ; Vankan-Buitelaar, Simone A ; Vonk, Mariska A A W ; Wiegers, Therese A ; Zwart, Joost J ; Franx, Arie ; Moons, Karel G M ; Koster, Maria P H</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b378t-fa1e7ef9139144c539f9a1c818ef8e3fdbbedfe89aca7c29d5003b9bdf52f3833</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Blood pressure</topic><topic>Body Mass Index</topic><topic>Calibration</topic><topic>Cohort analysis</topic><topic>Diabetes mellitus</topic><topic>Diabetes Mellitus - genetics</topic><topic>Diabetes, Gestational - epidemiology</topic><topic>Diabetes, Gestational - ethnology</topic><topic>Ethnicity</topic><topic>Female</topic><topic>Gestational diabetes</topic><topic>Glucose</topic><topic>Humans</topic><topic>Maternal Age</topic><topic>Medical prognosis</topic><topic>Netherlands - epidemiology</topic><topic>Ovaries</topic><topic>Parity</topic><topic>Patients</topic><topic>Polycystic ovary syndrome</topic><topic>Predictive Value of Tests</topic><topic>Pregnancy</topic><topic>Pregnancy complications</topic><topic>Pregnancy Trimester, First</topic><topic>Prospective Studies</topic><topic>Risk Assessment - methods</topic><topic>Risk Factors</topic><topic>Statistical analysis</topic><topic>Statistics as Topic</topic><topic>Systematic review</topic><topic>Validation studies</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lamain-de Ruiter, Marije</creatorcontrib><creatorcontrib>Kwee, Anneke</creatorcontrib><creatorcontrib>Naaktgeboren, Christiana A</creatorcontrib><creatorcontrib>de Groot, Inge</creatorcontrib><creatorcontrib>Evers, Inge M</creatorcontrib><creatorcontrib>Groenendaal, Floris</creatorcontrib><creatorcontrib>Hering, Yolanda R</creatorcontrib><creatorcontrib>Huisjes, Anjoke J M</creatorcontrib><creatorcontrib>Kirpestein, Cornel</creatorcontrib><creatorcontrib>Monincx, Wilma M</creatorcontrib><creatorcontrib>Siljee, Jacqueline E</creatorcontrib><creatorcontrib>Van ’t Zelfde, Annewil</creatorcontrib><creatorcontrib>van Oirschot, Charlotte M</creatorcontrib><creatorcontrib>Vankan-Buitelaar, Simone A</creatorcontrib><creatorcontrib>Vonk, Mariska A A W</creatorcontrib><creatorcontrib>Wiegers, Therese A</creatorcontrib><creatorcontrib>Zwart, Joost J</creatorcontrib><creatorcontrib>Franx, Arie</creatorcontrib><creatorcontrib>Moons, Karel G M</creatorcontrib><creatorcontrib>Koster, Maria P H</creatorcontrib><collection>BMJ Open Access Journals</collection><collection>BMJ Journals:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Index</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Research Library</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>BMJ (Online)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lamain-de Ruiter, Marije</au><au>Kwee, Anneke</au><au>Naaktgeboren, Christiana A</au><au>de Groot, Inge</au><au>Evers, Inge M</au><au>Groenendaal, Floris</au><au>Hering, Yolanda R</au><au>Huisjes, Anjoke J M</au><au>Kirpestein, Cornel</au><au>Monincx, Wilma M</au><au>Siljee, Jacqueline E</au><au>Van ’t Zelfde, Annewil</au><au>van Oirschot, Charlotte M</au><au>Vankan-Buitelaar, Simone A</au><au>Vonk, Mariska A A W</au><au>Wiegers, Therese A</au><au>Zwart, Joost J</au><au>Franx, Arie</au><au>Moons, Karel G M</au><au>Koster, Maria P H</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>External validation of prognostic models to predict risk of gestational diabetes mellitus in one Dutch cohort: prospective multicentre cohort study</atitle><jtitle>BMJ (Online)</jtitle><stitle>BMJ</stitle><addtitle>BMJ</addtitle><date>2016-08-30</date><risdate>2016</risdate><volume>354</volume><spage>i4338</spage><epage>i4338</epage><pages>i4338-i4338</pages><issn>1756-1833</issn><eissn>1756-1833</eissn><abstract>Objective To perform an external validation and direct comparison of published prognostic models for early prediction of the risk of gestational diabetes mellitus, including predictors applicable in the first trimester of pregnancy.Design External validation of all published prognostic models in large scale, prospective, multicentre cohort study.Setting 31 independent midwifery practices and six hospitals in the Netherlands.Participants Women recruited in their first trimester (<14 weeks) of pregnancy between December 2012 and January 2014, at their initial prenatal visit. Women with pre-existing diabetes mellitus of any type were excluded. Main outcome measures Discrimination of the prognostic models was assessed by the C statistic, and calibration assessed by calibration plots. Results 3723 women were included for analysis, of whom 181 (4.9%) developed gestational diabetes mellitus in pregnancy. 12 prognostic models for the disorder could be validated in the cohort. C statistics ranged from 0.67 to 0.78. Calibration plots showed that eight of the 12 models were well calibrated. The four models with the highest C statistics included almost all of the following predictors: maternal age, maternal body mass index, history of gestational diabetes mellitus, ethnicity, and family history of diabetes. Prognostic models had a similar performance in a subgroup of nulliparous women only. Decision curve analysis showed that the use of these four models always had a positive net benefit.Conclusions In this external validation study, most of the published prognostic models for gestational diabetes mellitus show acceptable discrimination and calibration. The four models with the highest discriminative abilities in this study cohort, which also perform well in a subgroup of nulliparous women, are easy models to apply in clinical practice and therefore deserve further evaluation regarding their clinical impact.</abstract><cop>England</cop><pub>British Medical Journal Publishing Group</pub><pmid>27576867</pmid><doi>10.1136/bmj.i4338</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Blood pressure Body Mass Index Calibration Cohort analysis Diabetes mellitus Diabetes Mellitus - genetics Diabetes, Gestational - epidemiology Diabetes, Gestational - ethnology Ethnicity Female Gestational diabetes Glucose Humans Maternal Age Medical prognosis Netherlands - epidemiology Ovaries Parity Patients Polycystic ovary syndrome Predictive Value of Tests Pregnancy Pregnancy complications Pregnancy Trimester, First Prospective Studies Risk Assessment - methods Risk Factors Statistical analysis Statistics as Topic Systematic review Validation studies Womens health |
| title | External validation of prognostic models to predict risk of gestational diabetes mellitus in one Dutch cohort: prospective multicentre cohort study |
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