The use of rigorous methods was strongly warranted among prognostic prediction models for obstetric care

Abstract

Objective: The objective of the study was to examine methodological characteristics about the design and conduct in prognostic prediction models used for obstetric care.

Study design and setting: We searched PubMed for studies on prognostic prediction models for obstetric care, published in top general medicine or major specialty journals between January 2011 and February 2018. Teams of method-trained investigators independently screened titles and abstracts and collected data using a prespecified, pilot-tested, structured questionnaire.

Results: In total, 91 studies were eligible, of which two were published in top general medicine journals, 20 (22.0%) involved an epidemiologist or statistician, 18 (19.4%) published study protocols, 53 (58.2%) did not include any model validation, 20 (22.0%) did not clearly state the intended timing of use, 23 (25.3%) had no eligibility criteria, 15 (16.5%) did not use clear criteria for ascertaining outcome, and 69 (75.82%) did not apply blinding to outcome assessment. Among those models, 11 (12.1%) included participants fewer than 200 events, 41 (48.8%) had fewer than 100 events, and 19 (24.7%) had fewer than 10 events per variable.

Conclusion: The prognostic prediction models have important limitations in design and conduct. Substantial efforts are needed to strengthen the production of reliable prognostic prediction models for obstetric care.

Keywords: Conduct; Design; Methodological survey; Obstetric care; Prediction model; Prognosis.