{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T21:27:22Z","timestamp":1776461242702,"version":"3.51.2"},"reference-count":29,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,11,30]],"date-time":"2021-11-30T00:00:00Z","timestamp":1638230400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To perform a temporal and geographical validation of a prognostic model, considered of highest methodological quality in a recently published systematic review, for predicting survival in very preterm infants admitted to the neonatal intensive care unit. The original model was developed in the UK and included gestational age, birthweight and gender.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>External validation study in a population\u2010based cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Dutch neonatal wards.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population or sample<\/jats:title><jats:p>All admitted white, singleton infants born between 23<jats:sup>+0<\/jats:sup> and 32<jats:sup>+6<\/jats:sup>\u2009weeks of gestation between 1 January 2015 and 31 December 2019. Additionally, the model\u2019s performance was assessed in four populations of admitted infants born between 24<jats:sup>+0<\/jats:sup> and 31<jats:sup>+6<\/jats:sup>\u2009weeks of gestation: white singletons, non\u2010white singletons, all singletons and all multiples.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The original model was applied in all five validation sets. Model performance was assessed in terms of calibration and discrimination and, if indicated, it was updated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Calibration (calibration\u2010in\u2010the\u2010large and calibration slope) and discrimination (<jats:italic>c<\/jats:italic> statistic).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Out of 6092 infants, 5659 (92.9%) survived. The model showed good external validity as indicated by good discrimination (<jats:italic>c<\/jats:italic> statistic 0.82, 95% CI 0.79\u20130.84) and calibration (calibration\u2010in\u2010the\u2010large 0.003, calibration slope 0.92, 95% CI 0.84\u20131.00). The model also showed good external validity in the other singleton populations, but required a small intercept update in the multiples population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A high\u2010quality prognostic model predicting survival in very preterm infants had good external validity in an independent, nationwide cohort. The accurate performance of the model indicates that after impact assessment, implementation of the model in clinical practice in the neonatal intensive care unit could be considered.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>A high\u2010quality model predicting survival in very preterm infants is externally valid in an independent cohort.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.17010","type":"journal-article","created":{"date-parts":[[2021,11,15]],"date-time":"2021-11-15T08:39:09Z","timestamp":1636965549000},"page":"529-538","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Prognostic model for predicting survival in very preterm infants: an external validation study"],"prefix":"10.1111","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8553-3241","authenticated-orcid":false,"given":"PE","family":"van Beek","sequence":"first","affiliation":[{"name":"Department of Neonatology M\u00e1xima Medical Centre Veldhoven The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F","family":"Groenendaal","sequence":"additional","affiliation":[{"name":"Department of Neonatology Wilhelmina Children\u2019s Hospital University Medical Centre Utrecht and Utrecht University Utrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W","family":"Onland","sequence":"additional","affiliation":[{"name":"Department of Neonatology Emma Children\u2019s Hospital Amsterdam University Medical Centres VU University Medical Centre University of Amsterdam Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S","family":"Koole","sequence":"additional","affiliation":[{"name":"The Netherlands Perinatal Registry Utrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"PH","family":"Dijk","sequence":"additional","affiliation":[{"name":"Department of Neonatology Beatrix Children\u2019s Hospital University Medical Centre Groningen University of Groningen Groningen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"KP","family":"Dijkman","sequence":"additional","affiliation":[{"name":"Department of Neonatology M\u00e1xima Medical Centre Veldhoven The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"FAM","family":"van den Dungen","sequence":"additional","affiliation":[{"name":"Department of Neonatology Emma Children\u2019s Hospital Amsterdam University Medical Centres VU University Medical Centre University of Amsterdam Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"AFJ","family":"van Heijst","sequence":"additional","affiliation":[{"name":"Department of Neonatology Amalia Children\u2019s Hospital Radboud University Medical Centre Nijmegen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"RF","family":"Kornelisse","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Division of Neonatology Erasmus MC University Medical Centre Rotterdam Rotterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"FABA","family":"Schuerman","sequence":"additional","affiliation":[{"name":"Department of Neonatology Isala Clinics Zwolle The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E","family":"van Westering\u2010Kroon","sequence":"additional","affiliation":[{"name":"Department of Neonatology Maastricht University Medical Centre Maastricht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"RSGM","family":"Witlox","sequence":"additional","affiliation":[{"name":"Department of Neonatology Willem\u2010Alexander Children\u2019s Hospital Leiden University Medical Centre Leiden The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P","family":"Andriessen","sequence":"additional","affiliation":[{"name":"Department of Neonatology M\u00e1xima Medical Centre Veldhoven The Netherlands"},{"name":"Department of Applied Physics School of Medical Physics and Engineering Eindhoven University of Technology Eindhoven The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E","family":"Schuit","sequence":"additional","affiliation":[{"name":"Julius Centre for Health Sciences and Primary Care University Medical Centre Utrecht Utrecht University Utrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"EPI\u2010DAF study group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,11,30]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"WHO.Preterm birth. 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