Adoption in Canada of International Risk Scoring Tool to Predict Respiratory Syncytial Virus Hospitalization in Moderate-to-Late Preterm Infants (32–35 Weeks’ Gestational Age)
Notice bibliographique
Résumé
Introduction The advisory board to the Ontario Ministry of Health is considering adoption of the new three-variable International Risk Scoring Tool (IRST), which used data pooled from six observational studies (including PICNIC from Canada) to predict RSVH in 32 to 35 wGA infants (Blanken. PediatrPulmonol2018;53:605–12). Canada is currently using a seven-variable RST developed solely from PICNIC focused on 33 to 35 weeks’ gestational age (wGA) infants (Sampalis. Med Decis Making 2008; 28:471–80]. We explored the potential implications of switching from the Canadian to the IRST. Materials and Methods The two RSTs were compared for included risk factors and predictive accuracy (area under the receiver operating characteristic curve). Correlations (Spearman rank) between cut-off scores for low-, moderate-, and high-risk subjects were assessed against the pooled dataset using infants born 33 to 35 wGA with complete data for all risk factors in both RSTs. Results Please refer to [ Table A012 ] for a summary of main results. In details, the two RSTs contain many of the same risk factors (birth proximity to the RSV season, smoking, siblings, and day care), with the Canadian RST also including sex, small for GA, and familial eczema. Predictive accuracy of the two RSTs is similar (AUROC, IRST: 0.773 [sensitivity: 68.9%; specificity: 73.0%] vs. Canadian: 0.762 [68.2%; 71.9%]). Significant correlations between cut-off scores ( p < 0.001) and risk categories ( p < 0.001) were apparent, although the correlation coefficients were weak for both (scores: 0.217; categories: 0.055). While the proportion of high-risk infants was similar for the two RSTs (IRST: 0.6% vs. Canadian: 0.7%), a far greater number of infants were assigned moderate-risk by the IRST (19.9% vs. Canadian: 9.8%). Conclusion The IRST can be considered a simpler model (few risk factors) than the Canadian RST, but assigns more infants as moderate-risk. Combined with including 32 wGA infants, adoption of the IRST in Canada has cost-effective implications for RSV prophylaxis which warrants further investigation. Table A012 RST n Score Number in each risk category High Moderate Low 4,529 0–100 27 (0.6%) 443 (9.8%) 4,059 (89.6%) Canadian Small (<10th percentile) gestational age (yes or no) Sex (male vs. female) Born during RSV season a Family history of eczema (yes or no) Subject or siblings attending day care (yes or no) >5 individuals in the home, including subject (yes or no) >1 smoker in the household (yes or no) RSVH rate (%) 11.2% 4.3% 1.0% IRST 4,529 0–56 31 (0.7%) 902 (19.9%) 3,596 (79.4%) Birth 3 months before and 2 months after season start date (yes or no) Smokers in the household and/or while pregnant (neither, either, or both) Siblings (excluding multiples) and/or (planned) day care (neither, either, or both) RSVH rate (%) 9.5% 3.3% 1.0% Abbreviations: IRST, international RST; RST, risk scoring tool; RSVH, respiratory syncytial virus hospitalization. a November–January. Conflict of Interest None declared.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,011 | 0,027 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,002 | 0,003 |
| Études des sciences et des technologies | 0,002 | 0,001 |
| Communication savante | 0,002 | 0,001 |
| Science ouverte | 0,002 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».