Key result
Prenatal ultrasound model predicts aortic coarctation with ~98% sensitivity and 0.8 AUROC.
Why the study?
Accurate antenatal diagnosis and risk stratification of coarctation of the aorta (CoA) remain challenging, necessitating a predictive model incorporating prenatal cardiac sonographic markers.
Does a multi-parametric prediction model incorporating prenatal cardiac sonographic markers improve the accuracy of risk assessment for coarctation of the aorta in fetuses?
Cohort (n=175)
Blinded to outcomes
Yes
Does a multi-parametric prediction model incorporating prenatal cardiac sonographic markers improve the accuracy of risk assessment for coarctation of the aorta in fetuses?
Answers are grounded in this paper and cite their sources.
A multi-parametric prediction model incorporating prenatal cardiac sonographic markers can accurately estimate the risk of coarctation of the aorta in fetuses, aiding in risk stratification and clinical decision-making.
Purpose: This study aimed to develop a coarctation probability model incorporating prenatal cardiac sonographic markers to estimate the probability of an antenatal diagnosis of coarctation of the aorta (CoA). Methods: We reviewed 89 fetuses as a“investigation” cohort with prenatal suspicion for CoA and allotted to three ssubgroups:(1) severe CoA: symptoms onset of CoA and surgery within the first three months (15);(2) mild CoA: surgery within four months-one year (29); (3) false-positive CoA: this outcome does not require surgery (45). Using logistic regression to creat the multi-parametric model, and validated using a “validation” cohort of 86 fetuses with suspected CoA subsequently.Results: The prediction model had optimal criterion >0.25 with sensitivity 97.7% and specificity 59.1%, the area under the receiver operator curve is 0.8 which makes sense in diagnosis of CoA and risk stratification. The risk assessment demonstrated that fetuses with model probability>60% should make an inpatient observation for high risk of CoA whereas <15% should not undergo clinical follow-up imaging.Conclusion: Based on these results, we recommend measuring the model in all fetuses with suspected CoA may improve the accuracy of risk assessment. The objectivity of its parameters may allow its implementation working in multicenter studies of fetal cardiology.
No takes yet. Share an insight, caveat, or question.
Wang et al. (2021) conducted a cohort in Prenatal suspicion for coarctation of the aorta (n=175). Clinical prediction model incorporating prenatal cardiac sonographic markers was evaluated on Probability of an antenatal diagnosis of coarctation of the aorta (AUROC 0.8). A clinical prediction model incorporating prenatal cardiac sonographic markers demonstrated an area under the curve of 0.8, with 97.7% sensitivity and 59.1% specificity for predicting coarctation of the aorta.