Peng Hai-Bo, Zhan Yuan-Li, Chen You, Jin Zhen-Chao, Liu Fang, Wang Bo, Yu Zhang-Bin
Department of Neonatology, Affiliated Shenzhen Baoan Women's and Children's Hospital, Jinan University, Shenzhen, China.
Department of Pediatrics, The Affiliated Suqian First People's Hospital of Nanjing Medical University, Suqian, China.
Front Pediatr. 2022 May 12;10:856159. doi: 10.3389/fped.2022.856159. eCollection 2022.
To provide an overview and critical appraisal of prediction models for bronchopulmonary dysplasia (BPD) in preterm infants.
We searched PubMed, Embase, and the Cochrane Library to identify relevant studies (up to November 2021). We included studies that reported prediction model development and/or validation of BPD in preterm infants born at ≤32 weeks and/or ≤1,500 g birth weight. We extracted the data independently based on the CHecklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies (CHARMS). We assessed risk of bias and applicability independently using the Prediction model Risk Of Bias ASsessment Tool (PROBAST).
Twenty-one prediction models from 13 studies reporting on model development and 21 models from 10 studies reporting on external validation were included. Oxygen dependency at 36 weeks' postmenstrual age was the most frequently reported outcome in both development studies (71%) and validation studies (81%). The most frequently used predictors in the models were birth weight (67%), gestational age (62%), and sex (52%). Nearly all included studies had high risk of bias, most often due to inadequate analysis. Small sample sizes and insufficient event patients were common in both study types. Missing data were often not reported or were discarded. Most studies reported on the models' discrimination, while calibration was seldom assessed (development, 19%; validation, 10%). Internal validation was lacking in 69% of development studies.
The included studies had many methodological shortcomings. Future work should focus on following the recommended approaches for developing and validating BPD prediction models.
对早产儿支气管肺发育不良（BPD）预测模型进行综述和批判性评价。
检索PubMed、Embase和Cochrane图书馆以识别相关研究（截至2021年11月）。我们纳入了报告≤32周出生和/或出生体重≤1500克的早产儿BPD预测模型开发和/或验证的研究。我们根据预测模型研究系统评价的批判性评价和数据提取清单（CHARMS）独立提取数据。我们使用预测模型偏倚风险评估工具（PROBAST）独立评估偏倚风险和适用性。
纳入了13项报告模型开发的研究中的21个预测模型和10项报告外部验证的研究中的21个模型。在发育研究（71%）和验证研究（81%）中，孕龄36周时的氧依赖是最常报告的结局。模型中最常用的预测因素是出生体重（67%）、胎龄（62%）和性别（52%）。几乎所有纳入研究都有较高的偏倚风险，最常见的原因是分析不充分。两种研究类型中样本量小和事件患者不足很常见。缺失数据往往未报告或被丢弃。大多数研究报告了模型的区分度，而校准很少被评估（发育研究为19%；验证研究为10%）。69%的发育研究缺乏内部验证。
纳入的研究存在许多方法学缺陷。未来的工作应专注于遵循推荐的方法来开发和验证BPD预测模型。
