External Validation and Calibration of IVFpredict: A National Prospective Cohort Study of 130,960 In Vitro Fertilisation Cycles
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{"title"=>"External validation and calibration of IVFpredict:A national prospective cohort study of 130,960 in vitro fertilisation Cycles", "type"=>"journal", "authors"=>[{"first_name"=>"Andrew D.A.C.", "last_name"=>"Smith", "scopus_author_id"=>"55676047300"}, {"first_name"=>"Kate", "last_name"=>"Tilling", "scopus_author_id"=>"7004134399"}, {"first_name"=>"Debbie A.", "last_name"=>"Lawlor", "scopus_author_id"=>"7102452820"}, {"first_name"=>"Scott M.", "last_name"=>"Nelson", "scopus_author_id"=>"12776474100"}], "year"=>2015, "source"=>"PLoS ONE", "identifiers"=>{"issn"=>"19326203", "pui"=>"604108472", "sgr"=>"84928902463", "doi"=>"10.1371/journal.pone.0121357", "scopus"=>"2-s2.0-84928902463"}, "id"=>"01a557da-426b-3141-9286-cb35ea679257", "abstract"=>"Background Accurately predicting the probability of a live birth after in vitro fertilisation (IVF) is important for patients, healthcare providers and policy makers. Two prediction models (Templeton and IVFpredict) have been previously developed from UK data and are widely used internationally. The more recent of these, IVFpredict, was shown to have greater predictive power in the development dataset. The aim of this study was external validation of the two models and comparison of their predictive ability. Methods and Findings 130,960 IVF cycles undertaken in the UK in 2008-2010 were used to validate and compare the Templeton and IVFpredict models. Discriminatory power was calculated using the area under the receiver-operator curve and calibration assessed using a calibration plot and Hosmer-Lemeshow statistic. The scaled modified Brier score, with measures of reliability and resolution, were calculated to assess overall accuracy. Both models were compared after updating for current live birth rates to ensure that the average observed and predicted live birth rates were equal. The discriminative power of both methods was comparable: the area under the receiver-operator curve was 0.628 (95% confidence interval (CI): 0.625-0.631) for IVFpredict and 0.616 (95% CI: 0.613-0.620) for the Templeton model. IVFpredict had markedly better calibration and higher diagnostic accuracy, with calibration plot intercept of 0.040 (95% CI: 0.017-0.063) and slope of 0.932 (95% CI: 0.839 - 1.025) compared with 0.080 (95% CI: 0.044-0.117) and 1.419 (95% CI: 1.149-1.690) for the Templeton model. Both models underestimated the live birth rate, but this was particularly marked in the Templeton model. Updating the models to reflect improvements in live birth rates since the models were developed enhanced their performance, but IVFpredict remained superior. Conclusion External validation in a large population cohort confirms IVFpredict has superior discrimination and calibration for informing patients, clinicians and healthcare policy makers of the probability of live birth following IVF. Copyright © 2015 Smith et al.", "link"=>"http://www.mendeley.com/research/external-validation-calibration-ivfpredicta-national-prospective-cohort-study-130960-vitro-fertilisa", "reader_count"=>1, "reader_count_by_academic_status"=>{"Researcher"=>1}, "reader_count_by_user_role"=>{"Researcher"=>1}, "reader_count_by_subject_area"=>{"Nursing and Health Professions"=>1}, "reader_count_by_subdiscipline"=>{"Nursing and Health Professions"=>{"Nursing and Health Professions"=>1}}, "group_count"=>0}

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/2009958"], "description"=>"<p>* Based on 144,018 cycles occurring in the UK between 2003 and 2007 [<a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0121357#pone.0121357.ref012\" target=\"_blank\">12</a>].</p><p>** Model predicting decreasing probability of live birth with increasing female age.</p><p>*** Model predicting decreasing probability of live birth with increasing female age categories (18–34, 35–37, 38–39, 40–42, 43–44 and 45–50 years).</p><p>Area under the receiver-operator curve for IVFpredict and Templeton models, and female age alone, for predicting live birth from 130,960 IVF cycles.</p>", "links"=>[], "tags"=>["IVFpredict", "healthcare policy makers", "Templeton model", "ivf", "uk", "Vitro Fertilisation Cycles BackgroundAccurately", "ci", "Birth rates", "calibration plot intercept"], "article_id"=>1371341, "categories"=>["Uncategorised"], "users"=>["Andrew D. A. C. Smith", "Kate Tilling", "Debbie A. Lawlor", "Scott M. Nelson"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0121357.t002", "stats"=>{"downloads"=>0, "page_views"=>23, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Area_under_the_receiver_operator_curve_for_IVFpredict_and_Templeton_models_and_female_age_alone_for_predicting_live_birth_from_130_960_IVF_cycles_/1371341", "title"=>"Area under the receiver-operator curve for IVFpredict and Templeton models, and female age alone, for predicting live birth from 130,960 IVF cycles.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-04-08 02:50:30"}
  • {"files"=>["https://ndownloader.figshare.com/files/2009957"], "description"=>"<p>Characteristics of patients and treatment in the validation sample, consisting of 130,960 IVF cycles.</p>", "links"=>[], "tags"=>["IVFpredict", "healthcare policy makers", "Templeton model", "ivf", "uk", "Vitro Fertilisation Cycles BackgroundAccurately", "ci", "Birth rates", "calibration plot intercept"], "article_id"=>1371340, "categories"=>["Uncategorised"], "users"=>["Andrew D. A. C. Smith", "Kate Tilling", "Debbie A. Lawlor", "Scott M. Nelson"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0121357.t001", "stats"=>{"downloads"=>1, "page_views"=>13, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Characteristics_of_patients_and_treatment_in_the_validation_sample_consisting_of_130_960_IVF_cycles_/1371340", "title"=>"Characteristics of patients and treatment in the validation sample, consisting of 130,960 IVF cycles.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-04-08 02:50:30"}
  • {"files"=>["https://ndownloader.figshare.com/files/2009954"], "description"=>"<p>Based on 130,960 IVF cycles. Hosmer-Lemeshow test statistics: p<0.001. Solid line, IVFpredict model; dashed line, Templeton model; dotted, diagonal line, perfect prediction (reference).</p>", "links"=>[], "tags"=>["IVFpredict", "healthcare policy makers", "Templeton model", "ivf", "uk", "Vitro Fertilisation Cycles BackgroundAccurately", "ci", "Birth rates", "calibration plot intercept"], "article_id"=>1371337, "categories"=>["Uncategorised"], "users"=>["Andrew D. A. C. Smith", "Kate Tilling", "Debbie A. Lawlor", "Scott M. Nelson"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0121357.g002", "stats"=>{"downloads"=>1, "page_views"=>19, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Calibration_plot_for_the_IVFpredict_and_Templeton_models_/1371337", "title"=>"Calibration plot for the IVFpredict and Templeton models.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2015-04-08 02:50:30"}
  • {"files"=>["https://ndownloader.figshare.com/files/2009953"], "description"=>"<p>Inclusion/exclusion criteria and formation of the validation sample.</p>", "links"=>[], "tags"=>["IVFpredict", "healthcare policy makers", "Templeton model", "ivf", "uk", "Vitro Fertilisation Cycles BackgroundAccurately", "ci", "Birth rates", "calibration plot intercept"], "article_id"=>1371336, "categories"=>["Uncategorised"], "users"=>["Andrew D. A. C. Smith", "Kate Tilling", "Debbie A. Lawlor", "Scott M. Nelson"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0121357.g001", "stats"=>{"downloads"=>2, "page_views"=>21, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Inclusion_exclusion_criteria_and_formation_of_the_validation_sample_/1371336", "title"=>"Inclusion/exclusion criteria and formation of the validation sample.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2015-04-08 02:50:30"}
  • {"files"=>["https://ndownloader.figshare.com/files/2009960"], "description"=>"<p>Scaled modified Brier score = 1 + Scaled reliability—Scaled uncertainty.</p><p>Brier scores and decomposition for IVFpredict and Templeton models, from 130,960 IVF cycles.</p>", "links"=>[], "tags"=>["IVFpredict", "healthcare policy makers", "Templeton model", "ivf", "uk", "Vitro Fertilisation Cycles BackgroundAccurately", "ci", "Birth rates", "calibration plot intercept"], "article_id"=>1371343, "categories"=>["Uncategorised"], "users"=>["Andrew D. A. C. Smith", "Kate Tilling", "Debbie A. Lawlor", "Scott M. Nelson"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0121357.t004", "stats"=>{"downloads"=>0, "page_views"=>12, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Brier_scores_and_decomposition_for_IVFpredict_and_Templeton_models_from_130_960_IVF_cycles_/1371343", "title"=>"Brier scores and decomposition for IVFpredict and Templeton models, from 130,960 IVF cycles.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-04-08 02:50:30"}
  • {"files"=>["https://ndownloader.figshare.com/files/2009961"], "description"=>"<p>* Not including 3 cycles with equal prognosis in the updated IVFpredict and Templeton models.</p><p>Net reclassification index for IVFpredict compared with the Templeton model.</p>", "links"=>[], "tags"=>["IVFpredict", "healthcare policy makers", "Templeton model", "ivf", "uk", "Vitro Fertilisation Cycles BackgroundAccurately", "ci", "Birth rates", "calibration plot intercept"], "article_id"=>1371344, "categories"=>["Uncategorised"], "users"=>["Andrew D. A. C. Smith", "Kate Tilling", "Debbie A. Lawlor", "Scott M. Nelson"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0121357.t005", "stats"=>{"downloads"=>2, "page_views"=>15, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Net_reclassification_index_for_IVFpredict_compared_with_the_Templeton_model_/1371344", "title"=>"Net reclassification index for IVFpredict compared with the Templeton model.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-04-08 02:50:30"}
  • {"files"=>["https://ndownloader.figshare.com/files/2009959"], "description"=>"<p>P-values are for differences between observed and predicted number of live births, and those smaller than the threshold for a family-wise error rate of 5% are highlighted.</p><p>* Not including 5 cycles where cervical cause of infertility only, for which meaningful confidence intervals cannot be calculated.</p><p>Observed and predicted live birth rates from updated IVFpredict and Templeton models stratified by characteristics of patients and treatment, in 130,960 IVF cycles.</p>", "links"=>[], "tags"=>["IVFpredict", "healthcare policy makers", "Templeton model", "ivf", "uk", "Vitro Fertilisation Cycles BackgroundAccurately", "ci", "Birth rates", "calibration plot intercept"], "article_id"=>1371342, "categories"=>["Uncategorised"], "users"=>["Andrew D. A. C. Smith", "Kate Tilling", "Debbie A. Lawlor", "Scott M. Nelson"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0121357.t003", "stats"=>{"downloads"=>7, "page_views"=>15, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Observed_and_predicted_live_birth_rates_from_updated_IVFpredict_and_Templeton_models_stratified_by_characteristics_of_patients_and_treatment_in_130_960_IVF_cycles_/1371342", "title"=>"Observed and predicted live birth rates from updated IVFpredict and Templeton models stratified by characteristics of patients and treatment, in 130,960 IVF cycles.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-04-08 02:50:30"}
  • {"files"=>["https://ndownloader.figshare.com/files/2009956"], "description"=>"<p>Based on 130,960 IVF cycles. Hosmer-Lemeshow test statistics: p<0.001. Solid line, updated IVFpredict model; dashed line, updated Templeton model; dotted, diagonal line, perfect prediction (reference).</p>", "links"=>[], "tags"=>["IVFpredict", "healthcare policy makers", "Templeton model", "ivf", "uk", "Vitro Fertilisation Cycles BackgroundAccurately", "ci", "Birth rates", "calibration plot intercept"], "article_id"=>1371339, "categories"=>["Uncategorised"], "users"=>["Andrew D. A. C. Smith", "Kate Tilling", "Debbie A. Lawlor", "Scott M. Nelson"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0121357.g003", "stats"=>{"downloads"=>1, "page_views"=>7, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Calibration_plot_for_updated_IVFpredict_and_Templeton_models_/1371339", "title"=>"Calibration plot for updated IVFpredict and Templeton models.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2015-04-08 02:50:30"}
  • {"files"=>["https://ndownloader.figshare.com/files/2009963", "https://ndownloader.figshare.com/files/2009964", "https://ndownloader.figshare.com/files/2009965"], "description"=>"<div><p>Background</p><p>Accurately predicting the probability of a live birth after in vitro fertilisation (IVF) is important for patients, healthcare providers and policy makers. Two prediction models (Templeton and IVFpredict) have been previously developed from UK data and are widely used internationally. The more recent of these, IVFpredict, was shown to have greater predictive power in the development dataset. The aim of this study was external validation of the two models and comparison of their predictive ability.</p><p>Methods and Findings</p><p>130,960 IVF cycles undertaken in the UK in 2008–2010 were used to validate and compare the Templeton and IVFpredict models. Discriminatory power was calculated using the area under the receiver-operator curve and calibration assessed using a calibration plot and Hosmer-Lemeshow statistic. The scaled modified Brier score, with measures of reliability and resolution, were calculated to assess overall accuracy. Both models were compared after updating for current live birth rates to ensure that the average observed and predicted live birth rates were equal. The discriminative power of both methods was comparable: the area under the receiver-operator curve was 0.628 (95% confidence interval (CI): 0.625–0.631) for IVFpredict and 0.616 (95% CI: 0.613–0.620) for the Templeton model. IVFpredict had markedly better calibration and higher diagnostic accuracy, with calibration plot intercept of 0.040 (95% CI: 0.017–0.063) and slope of 0.932 (95% CI: 0.839–1.025) compared with 0.080 (95% CI: 0.044–0.117) and 1.419 (95% CI: 1.149–1.690) for the Templeton model. Both models underestimated the live birth rate, but this was particularly marked in the Templeton model. Updating the models to reflect improvements in live birth rates since the models were developed enhanced their performance, but IVFpredict remained superior.</p><p>Conclusion</p><p>External validation in a large population cohort confirms IVFpredict has superior discrimination and calibration for informing patients, clinicians and healthcare policy makers of the probability of live birth following IVF.</p></div>", "links"=>[], "tags"=>["IVFpredict", "healthcare policy makers", "Templeton model", "ivf", "uk", "Vitro Fertilisation Cycles BackgroundAccurately", "ci", "Birth rates", "calibration plot intercept"], "article_id"=>1371346, "categories"=>["Uncategorised"], "users"=>["Andrew D. A. C. Smith", "Kate Tilling", "Debbie A. Lawlor", "Scott M. Nelson"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0121357.s001", "https://dx.doi.org/10.1371/journal.pone.0121357.s002", "https://dx.doi.org/10.1371/journal.pone.0121357.s003"], "stats"=>{"downloads"=>1, "page_views"=>15, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_External_Validation_and_Calibration_of_IVFpredict_A_National_Prospective_Cohort_Study_of_130_960_In_Vitro_Fertilisation_Cycles_/1371346", "title"=>"External Validation and Calibration of IVFpredict: A National Prospective Cohort Study of 130,960 In Vitro Fertilisation Cycles", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2015-04-08 02:50:30"}

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{"start_date"=>"2015-01-01T00:00:00Z", "end_date"=>"2015-12-31T00:00:00Z", "subject_areas"=>[]}
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