Abstract
Objective
To perform an external validation of a publicly available model predicting extubation success in very preterm infants.
Study design
Retrospective study of infants born <1250 g at a single center. Model performance evaluated using the area under the receiver operating characteristic curve (AUROC) and comparing observed and expected probabilities of extubation success, defined as survival ≥5 d without an endotracheal tube.
Results
Of 177 infants, 120 (68%) were extubated successfully. The median (IQR) gestational age was 27 weeks (25–28) and weight at extubation was 915 g (755–1050). The model had acceptable discrimination (AUROC 0.72 [95% CI 0.65–0.80]) and adequate calibration (calibration slope 0.96, intercept -0.06, mean observed-to-expected difference in probability of extubation success −0.08 [95% CI −0.01, −0.15]).
Conclusions
The extubation success prediction model has acceptable performance in an external cohort. Additional prospective studies are needed to determine if the model can be improved or how it can be used for clinical benefit.
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Data availability
The corresponding author can be contacted for source data.
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Contributions
BD conceived of and designed the study, acquired data and drafted the manuscript, AS and VS acquired data and critically revised the manuscript for important intellectual content, RG, MR, and SC guided analyses and interpretation of data and critically revised the manuscript for important intellectual content and RP conceived of and designed the study, analyzed the data, drafted the manuscript and provided study supervision.
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Supplementary information
41372_2022_1517_MOESM2_ESM.pdf
Supplementary Table 2. Sensitivity, Specificity, Youden’s J and Euclidean Distance at Various Extubation Success Probability Thresholds
41372_2022_1517_MOESM5_ESM.pdf
Supplementary Figure 2. Optimal Cut-Point of Predicted Probability of Extubation Success using Youden’s J and Euclidean distance
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Dryer, R.A., Salem, A., Saroha, V. et al. Evaluation and validation of a prediction model for extubation success in very preterm infants. J Perinatol 42, 1674–1679 (2022). https://doi.org/10.1038/s41372-022-01517-z
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DOI: https://doi.org/10.1038/s41372-022-01517-z
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