Development of a risk calculator to predict attention‐deficit/hyperactivity disorder in very preterm/very low birth weight newborns
Background Very preterm/very low birth weight (VP/VLBW) newborns can have lifelong morbidities, as attention‐deficit/hyperactivity disorder (ADHD). Clinicians have no markers to discriminate which among those individuals will develop later ADHD, based only on the clinical presentation at birth. Our...
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| Veröffentlicht in: | Journal of child psychology and psychiatry 2022-08, Vol.63 (8), p.929-938 |
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| creator | Franz, Adelar Pedro Caye, Arthur Lacerda, Bárbara Calil Wagner, Flávia Silveira, Rita C. Procianoy, Renato Soibelmann Moreira‐Maia, Carlos Renato Rohde, Luis Augusto |
| description | Background
Very preterm/very low birth weight (VP/VLBW) newborns can have lifelong morbidities, as attention‐deficit/hyperactivity disorder (ADHD). Clinicians have no markers to discriminate which among those individuals will develop later ADHD, based only on the clinical presentation at birth. Our aim was to develop an individualized risk calculator for ADHD in VP/VLBW newborns.
Methods
This retrospective prognostic study included a consecutive sample of all VP/VLBW children (gestational age |
| doi_str_mv | 10.1111/jcpp.13546 |
| format | Article |
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Very preterm/very low birth weight (VP/VLBW) newborns can have lifelong morbidities, as attention‐deficit/hyperactivity disorder (ADHD). Clinicians have no markers to discriminate which among those individuals will develop later ADHD, based only on the clinical presentation at birth. Our aim was to develop an individualized risk calculator for ADHD in VP/VLBW newborns.
Methods
This retrospective prognostic study included a consecutive sample of all VP/VLBW children (gestational age <32 weeks and/or birth weight <1.5 kg) born between 2010 and 2012 from a clinical cohort in a Brazilian tertiary care hospital. Children were clinically assessed at 6 years of age for ADHD using the Schedule for Affective Disorders and Schizophrenia for School‐Age Children (K‐SADS). The least absolute shrinkage and selection operator (LASSO) method was used for model‐building.
Results
Ninety‐six VP/VLBW children were assessed at 6 years of age (92% follow‐up), of whom 32 (33%) were diagnosed with ADHD. The area under the ROC curve (AUC) for ADHD prediction based on seven parameters (late‐onset sepsis confirmed by blood culture, necrotizing enterocolitis, neonatal seizures, periventricular leukomalacia, respiratory distress syndrome, length of hospital stay, and number of maternal ADHD symptoms) was .875 (CI, 0.800–0.942, p < .001; AUC corrected for optimism with bootstrapping: .806), a performance that is comparable to other medical risk calculators. Compared to approaches that would offer early intervention to all, or intervention to none, the risk calculator will be more useful in selecting VP/VLBW newborns, with statistically significant net benefits at cost:benefits of around 1:2 to around 10:6 (range of ADHD risk thresholds of 32%–62%, respectively). It also showed specificity for ADHD compared to other prevalent child psychopathologies.
Conclusions
The risk calculator showed good performance for early identification of VP/VLBW newborns at high risk of future ADHD diagnosis. External validity in population‐based samples is needed to extend clinical usefulness.</description><identifier>ISSN: 0021-9630</identifier><identifier>EISSN: 1469-7610</identifier><identifier>DOI: 10.1111/jcpp.13546</identifier><language>eng</language><publisher>Malden: Blackwell Publishing Ltd</publisher><subject>Age of onset ; Attention deficit hyperactivity disorder ; Birth weight ; Body Weight ; Bootstrap method ; Calculators ; Child & adolescent psychiatry ; Childbirth & labor ; Children ; Convulsions & seizures ; Early intervention ; Emotional disorders ; Enterocolitis ; Gestational age ; High risk ; Length of stay ; Low birth weight ; Medical diagnosis ; Necrotizing enterocolitis ; Neonates ; Newborn babies ; Optimism ; prediction ; Prematurity ; Psychological distress ; Respiratory distress syndrome ; Schizophrenia ; Sepsis ; Thresholds ; Usefulness</subject><ispartof>Journal of child psychology and psychiatry, 2022-08, Vol.63 (8), p.929-938</ispartof><rights>2021 Association for Child and Adolescent Mental Health.</rights><rights>Copyright © 2022 Association for Child and Adolescent Mental Health</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c2936-98c77e2c5934ddfda007ce1de6d4c740fa1e67f5d3792e5ae97972934cfa491e3</cites><orcidid>0000-0002-7301-1515 ; 0000-0002-4552-4188 ; 0000-0002-5341-7147 ; 0000-0003-1683-4870 ; 0000-0002-2982-2652 ; 0000-0001-8297-4164 ; 0000-0003-3342-3416 ; 0000-0002-1924-7105</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjcpp.13546$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjcpp.13546$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,30978,45553,45554</link.rule.ids></links><search><creatorcontrib>Franz, Adelar Pedro</creatorcontrib><creatorcontrib>Caye, Arthur</creatorcontrib><creatorcontrib>Lacerda, Bárbara Calil</creatorcontrib><creatorcontrib>Wagner, Flávia</creatorcontrib><creatorcontrib>Silveira, Rita C.</creatorcontrib><creatorcontrib>Procianoy, Renato Soibelmann</creatorcontrib><creatorcontrib>Moreira‐Maia, Carlos Renato</creatorcontrib><creatorcontrib>Rohde, Luis Augusto</creatorcontrib><title>Development of a risk calculator to predict attention‐deficit/hyperactivity disorder in very preterm/very low birth weight newborns</title><title>Journal of child psychology and psychiatry</title><description>Background
Very preterm/very low birth weight (VP/VLBW) newborns can have lifelong morbidities, as attention‐deficit/hyperactivity disorder (ADHD). Clinicians have no markers to discriminate which among those individuals will develop later ADHD, based only on the clinical presentation at birth. Our aim was to develop an individualized risk calculator for ADHD in VP/VLBW newborns.
Methods
This retrospective prognostic study included a consecutive sample of all VP/VLBW children (gestational age <32 weeks and/or birth weight <1.5 kg) born between 2010 and 2012 from a clinical cohort in a Brazilian tertiary care hospital. Children were clinically assessed at 6 years of age for ADHD using the Schedule for Affective Disorders and Schizophrenia for School‐Age Children (K‐SADS). The least absolute shrinkage and selection operator (LASSO) method was used for model‐building.
Results
Ninety‐six VP/VLBW children were assessed at 6 years of age (92% follow‐up), of whom 32 (33%) were diagnosed with ADHD. The area under the ROC curve (AUC) for ADHD prediction based on seven parameters (late‐onset sepsis confirmed by blood culture, necrotizing enterocolitis, neonatal seizures, periventricular leukomalacia, respiratory distress syndrome, length of hospital stay, and number of maternal ADHD symptoms) was .875 (CI, 0.800–0.942, p < .001; AUC corrected for optimism with bootstrapping: .806), a performance that is comparable to other medical risk calculators. Compared to approaches that would offer early intervention to all, or intervention to none, the risk calculator will be more useful in selecting VP/VLBW newborns, with statistically significant net benefits at cost:benefits of around 1:2 to around 10:6 (range of ADHD risk thresholds of 32%–62%, respectively). It also showed specificity for ADHD compared to other prevalent child psychopathologies.
Conclusions
The risk calculator showed good performance for early identification of VP/VLBW newborns at high risk of future ADHD diagnosis. External validity in population‐based samples is needed to extend clinical usefulness.</description><subject>Age of onset</subject><subject>Attention deficit hyperactivity disorder</subject><subject>Birth weight</subject><subject>Body Weight</subject><subject>Bootstrap method</subject><subject>Calculators</subject><subject>Child & adolescent psychiatry</subject><subject>Childbirth & labor</subject><subject>Children</subject><subject>Convulsions & seizures</subject><subject>Early intervention</subject><subject>Emotional disorders</subject><subject>Enterocolitis</subject><subject>Gestational age</subject><subject>High risk</subject><subject>Length of stay</subject><subject>Low birth weight</subject><subject>Medical diagnosis</subject><subject>Necrotizing enterocolitis</subject><subject>Neonates</subject><subject>Newborn babies</subject><subject>Optimism</subject><subject>prediction</subject><subject>Prematurity</subject><subject>Psychological distress</subject><subject>Respiratory distress syndrome</subject><subject>Schizophrenia</subject><subject>Sepsis</subject><subject>Thresholds</subject><subject>Usefulness</subject><issn>0021-9630</issn><issn>1469-7610</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>7QJ</sourceid><recordid>eNp90btOwzAUBmALgUS5LDyBJRaEFGonjh2PqNyFRAeYI9c-oS5pHGy3VTYWdp6RJyFtmRjwcmTp-4-O9CN0QskF7d9wptv2gmY54ztoQBmXieCU7KIBISlNJM_IPjoIYUYI4VleDNDnFSyhdu0cmohdhRX2NrxhrWq9qFV0HkeHWw_G6ohVjD2zrvn--DJQWW3jcNq14JWOdmljh40Nzhvw2DZ4Cb5bRyP4-XDzqd0KT6yPU7wC-zqNuIHVxPkmHKG9StUBjn_nIXq5uX4e3SWPT7f3o8vHRKcy44kstBCQ6lxmzJjKKEKEBmqAG6YFI5WiwEWVm0zIFHIFUkjRJ5muFJMUskN0tt3beve-gBDLuQ0a6lo14BahTDmhrChYwXt6-ofO3MI3_XW9klTKNBeiV-dbpb0LwUNVtt7Ole9KSsp1I-W6kXLTSI_pFq9sDd0_snwYjcfbzA9hRpJx</recordid><startdate>202208</startdate><enddate>202208</enddate><creator>Franz, Adelar Pedro</creator><creator>Caye, Arthur</creator><creator>Lacerda, Bárbara Calil</creator><creator>Wagner, Flávia</creator><creator>Silveira, Rita C.</creator><creator>Procianoy, Renato Soibelmann</creator><creator>Moreira‐Maia, Carlos Renato</creator><creator>Rohde, Luis Augusto</creator><general>Blackwell Publishing Ltd</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7301-1515</orcidid><orcidid>https://orcid.org/0000-0002-4552-4188</orcidid><orcidid>https://orcid.org/0000-0002-5341-7147</orcidid><orcidid>https://orcid.org/0000-0003-1683-4870</orcidid><orcidid>https://orcid.org/0000-0002-2982-2652</orcidid><orcidid>https://orcid.org/0000-0001-8297-4164</orcidid><orcidid>https://orcid.org/0000-0003-3342-3416</orcidid><orcidid>https://orcid.org/0000-0002-1924-7105</orcidid></search><sort><creationdate>202208</creationdate><title>Development of a risk calculator to predict attention‐deficit/hyperactivity disorder in very preterm/very low birth weight newborns</title><author>Franz, Adelar Pedro ; Caye, Arthur ; Lacerda, Bárbara Calil ; Wagner, Flávia ; Silveira, Rita C. ; Procianoy, Renato Soibelmann ; Moreira‐Maia, Carlos Renato ; Rohde, Luis Augusto</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2936-98c77e2c5934ddfda007ce1de6d4c740fa1e67f5d3792e5ae97972934cfa491e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Age of onset</topic><topic>Attention deficit hyperactivity disorder</topic><topic>Birth weight</topic><topic>Body Weight</topic><topic>Bootstrap method</topic><topic>Calculators</topic><topic>Child & adolescent psychiatry</topic><topic>Childbirth & labor</topic><topic>Children</topic><topic>Convulsions & seizures</topic><topic>Early intervention</topic><topic>Emotional disorders</topic><topic>Enterocolitis</topic><topic>Gestational age</topic><topic>High risk</topic><topic>Length of stay</topic><topic>Low birth weight</topic><topic>Medical diagnosis</topic><topic>Necrotizing enterocolitis</topic><topic>Neonates</topic><topic>Newborn babies</topic><topic>Optimism</topic><topic>prediction</topic><topic>Prematurity</topic><topic>Psychological distress</topic><topic>Respiratory distress syndrome</topic><topic>Schizophrenia</topic><topic>Sepsis</topic><topic>Thresholds</topic><topic>Usefulness</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Franz, Adelar Pedro</creatorcontrib><creatorcontrib>Caye, Arthur</creatorcontrib><creatorcontrib>Lacerda, Bárbara Calil</creatorcontrib><creatorcontrib>Wagner, Flávia</creatorcontrib><creatorcontrib>Silveira, Rita C.</creatorcontrib><creatorcontrib>Procianoy, Renato Soibelmann</creatorcontrib><creatorcontrib>Moreira‐Maia, Carlos Renato</creatorcontrib><creatorcontrib>Rohde, Luis Augusto</creatorcontrib><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of child psychology and psychiatry</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Franz, Adelar Pedro</au><au>Caye, Arthur</au><au>Lacerda, Bárbara Calil</au><au>Wagner, Flávia</au><au>Silveira, Rita C.</au><au>Procianoy, Renato Soibelmann</au><au>Moreira‐Maia, Carlos Renato</au><au>Rohde, Luis Augusto</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Development of a risk calculator to predict attention‐deficit/hyperactivity disorder in very preterm/very low birth weight newborns</atitle><jtitle>Journal of child psychology and psychiatry</jtitle><date>2022-08</date><risdate>2022</risdate><volume>63</volume><issue>8</issue><spage>929</spage><epage>938</epage><pages>929-938</pages><issn>0021-9630</issn><eissn>1469-7610</eissn><abstract>Background
Very preterm/very low birth weight (VP/VLBW) newborns can have lifelong morbidities, as attention‐deficit/hyperactivity disorder (ADHD). Clinicians have no markers to discriminate which among those individuals will develop later ADHD, based only on the clinical presentation at birth. Our aim was to develop an individualized risk calculator for ADHD in VP/VLBW newborns.
Methods
This retrospective prognostic study included a consecutive sample of all VP/VLBW children (gestational age <32 weeks and/or birth weight <1.5 kg) born between 2010 and 2012 from a clinical cohort in a Brazilian tertiary care hospital. Children were clinically assessed at 6 years of age for ADHD using the Schedule for Affective Disorders and Schizophrenia for School‐Age Children (K‐SADS). The least absolute shrinkage and selection operator (LASSO) method was used for model‐building.
Results
Ninety‐six VP/VLBW children were assessed at 6 years of age (92% follow‐up), of whom 32 (33%) were diagnosed with ADHD. The area under the ROC curve (AUC) for ADHD prediction based on seven parameters (late‐onset sepsis confirmed by blood culture, necrotizing enterocolitis, neonatal seizures, periventricular leukomalacia, respiratory distress syndrome, length of hospital stay, and number of maternal ADHD symptoms) was .875 (CI, 0.800–0.942, p < .001; AUC corrected for optimism with bootstrapping: .806), a performance that is comparable to other medical risk calculators. Compared to approaches that would offer early intervention to all, or intervention to none, the risk calculator will be more useful in selecting VP/VLBW newborns, with statistically significant net benefits at cost:benefits of around 1:2 to around 10:6 (range of ADHD risk thresholds of 32%–62%, respectively). It also showed specificity for ADHD compared to other prevalent child psychopathologies.
Conclusions
The risk calculator showed good performance for early identification of VP/VLBW newborns at high risk of future ADHD diagnosis. External validity in population‐based samples is needed to extend clinical usefulness.</abstract><cop>Malden</cop><pub>Blackwell Publishing Ltd</pub><doi>10.1111/jcpp.13546</doi><tpages>938</tpages><orcidid>https://orcid.org/0000-0002-7301-1515</orcidid><orcidid>https://orcid.org/0000-0002-4552-4188</orcidid><orcidid>https://orcid.org/0000-0002-5341-7147</orcidid><orcidid>https://orcid.org/0000-0003-1683-4870</orcidid><orcidid>https://orcid.org/0000-0002-2982-2652</orcidid><orcidid>https://orcid.org/0000-0001-8297-4164</orcidid><orcidid>https://orcid.org/0000-0003-3342-3416</orcidid><orcidid>https://orcid.org/0000-0002-1924-7105</orcidid></addata></record> |
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| source | Wiley Online Library Journals Frontfile Complete; Applied Social Sciences Index & Abstracts (ASSIA) |
| subjects | Age of onset Attention deficit hyperactivity disorder Birth weight Body Weight Bootstrap method Calculators Child & adolescent psychiatry Childbirth & labor Children Convulsions & seizures Early intervention Emotional disorders Enterocolitis Gestational age High risk Length of stay Low birth weight Medical diagnosis Necrotizing enterocolitis Neonates Newborn babies Optimism prediction Prematurity Psychological distress Respiratory distress syndrome Schizophrenia Sepsis Thresholds Usefulness |
| title | Development of a risk calculator to predict attention‐deficit/hyperactivity disorder in very preterm/very low birth weight newborns |
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