Improving accuracy of outcome prediction for infants born extremely preterm using a digital tool: Translating ‘NIC-PREDICT’ into clinical practice, the first steps

IF 1.4 4区 医学 Q3 OBSTETRICS & GYNECOLOGY
Rosemarie A. Boland, Jeanie L.Y. Cheong, Michael J. Stewart, Stefan C. Kane, Lex W. Doyle
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引用次数: 0

Abstract

Background

Many clinicians overestimate mortality and disability rates in infants born extremely preterm. We developed a digital tool (‘NIC-PREDICT’) that predicts infant mortality and survival with and without major disability in infants born 23–27 weeks' gestation.

Aims

To determine if clinicians could use NIC-PREDICT accurately, and if their perceptions of infant outcomes improved after its release in 2021.

Materials and Methods

Midwives, nurses, obstetricians, neonatologists and paediatricians working in tertiary and non-tertiary hospitals in Victoria were asked to use NIC-PREDICT to estimate three mutually exclusive outcomes: (i) mortality; (ii) survival free of major disability; and (iii) survival with major disability for six different scenarios where a liveborn infant was offered survival-focused care after birth. The proportions who completed the survey (responded to all six scenarios) and the proportions able to provide 100% accurate results for all scenarios were determined. Estimates of the three outcomes were compared with true rates.

Results

A total of 85 clinicians responded: 70 (82%) completed the survey, with an overall accuracy of 76%. Overall, predictions of mortality were accurate (mean difference from true value 0.7% (95% confidence interval (CI) −0.7, 2.1) P = 0.33), as were predictions of survival without major disability (mean difference − 0.7 (95% CI –3.0, 1.7) P = 0.58). However, survival with major disability was overestimated by 4.9% ((95% CI 1.7, 8.0) P = 0.003).

Conclusions

Most perinatal clinicians who responded used NIC-PREDICT correctly to estimate expected outcomes in infants born extremely preterm who are offered intensive care. Undue pessimism about survival with major disability remains an ongoing concern.

Abstract Image

利用数字工具提高极早产儿预后预测的准确性:将 "NIC-PREDICT "转化为临床实践的第一步
许多临床医生高估了极早产儿的死亡率和残疾率。我们开发了一种数字工具("NIC-PREDICT"),可预测妊娠 23-27 周出生婴儿的死亡率和存活率,以及有无严重残疾。
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来源期刊
CiteScore
3.40
自引率
11.80%
发文量
165
审稿时长
4-8 weeks
期刊介绍: The Australian and New Zealand Journal of Obstetrics and Gynaecology (ANZJOG) is an editorially independent publication owned by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) and the RANZCOG Research foundation. ANZJOG aims to provide a medium for the publication of original contributions to clinical practice and/or research in all fields of obstetrics and gynaecology and related disciplines. Articles are peer reviewed by clinicians or researchers expert in the field of the submitted work. From time to time the journal will also publish printed abstracts from the RANZCOG Annual Scientific Meeting and meetings of relevant special interest groups, where the accepted abstracts have undergone the journals peer review acceptance process.
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