{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:52:36Z","timestamp":1786978356224,"version":"build-2736575974"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,5,25]],"date-time":"2023-05-25T00:00:00Z","timestamp":1684972800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Prenatal Diagnosis"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>A nomogram for predicting the diagnosis of lower urinary tract obstruction (LUTO) based on an antenatal ultrasound index generated from a Bayesian Meta\u2010regression analysis has been in development and noted with superior diagnostic accuracy compared to the keyhole sign (KHS). We aim to assess the accuracy of the nomogram in expanded diagnostic utilization to predict LUTO.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodology<\/jats:title>\n                    <jats:p>The validation of the nomogram for expanded diagnostic utilization was based on data from a prospective institutional antenatal clinic database between January 2020 and June 2022. Diagnostic accuracy indices were determined for confirmed postnatal diagnosis of LUTO or prune belly syndrome (PBS). Receiver operating characteristics (ROC) curves were generated to compare the area under the curve (AUC) of the nomogram versus KHS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Based on 84 male fetuses with antenatal ultrasound of moderate\u2010severe hydronephrosis (PUV\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a015, PBS\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a04), the KHS had 26.3% (95%CI 9.1\u201351.2) sensitivity and 100% (95%CI 94.4%\u2013100%) specificity, with 14 false\u2010negatives. The nomogram showed a 84.2 (95%CI 60.4%\u201396.6%) sensitivity and 95.4 (95%CI 87.1%\u201399%) specificity with three false\u2010positives. The nomogram also had a superior AUC compared to KHS (0.98 vs. 0.63).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The nomogram can be used as a valuable tool to trigger further postnatal screening and provide individualized risk assessments to families during prenatal counseling.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pd.6384","type":"journal-article","created":{"date-parts":[[2023,5,11]],"date-time":"2023-05-11T02:01:36Z","timestamp":1683770496000},"page":"117-123","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Toronto nomogram: A Bayesian meta\u2010regression derived prenatal ultrasound index to predict lower urinary tract obstruction and prune belly syndrome"],"prefix":"10.1002","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0598-1824","authenticated-orcid":false,"given":"Mandy","family":"Rickard","sequence":"first","affiliation":[{"name":"Divison of Urology Hospital for Sick Children  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin Kyu","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3034-6905","authenticated-orcid":false,"given":"Tim","family":"Van Mieghem","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Mount Sinai Hospital and University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6352-4846","authenticated-orcid":false,"given":"Shiri","family":"Shinar","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Mount Sinai Hospital and University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashlene","family":"McKay","sequence":"additional","affiliation":[{"name":"Division of Nephrology Hospital for Sick Children  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joana Dos","family":"Santos","sequence":"additional","affiliation":[{"name":"Divison of Urology Hospital for Sick Children  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natasha","family":"Brownrigg","sequence":"additional","affiliation":[{"name":"Divison of Urology Hospital for Sick Children  Toronto Ontario 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