Simple adaptations to the Templeton model for IVF outcome prediction make it current and clinically useful
Identifieur interne : 005917 ( Main/Exploration ); précédent : 005916; suivant : 005918Simple adaptations to the Templeton model for IVF outcome prediction make it current and clinically useful
Auteurs : P. Arvis [France] ; P. Lehert [Belgique, Australie] ; A. Guivarc'H-Leveque [France]Source :
- Human reproduction : (Oxford. Print) [ 0268-1161 ] ; 2012.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
Abstract
STUDY QUESTION: What is the validity of the Templeton model (TM) in predicting live birth (LB) for a couple starting an IVF/ICSI cycle? SUMMARY ANSWER: A centre-specific model based on the original predictors of the TM may reach a sufficient level of accuracy to be used in every day practice, with a few simple adaptations. WHAT IS KNOWN AND WHAT THIS PAPER ADDS: The TM seems the best predictive model of LB in IVF. However, previous validations of the TM suggest a lack of discrimination and calibration which means that it is not used in regular practice. We confirm this finding, and argue that such results are predictable, and essentially due to a strong centre effect. We provide evidence that the TM constitutes a useful reference reflecting a high proportion of the patient-mix effect since the parameters of the model remain invariant among centres, but also across various cultures, countries and types of hospitals. The only difference was the intercept value, interpreted as the measurement of the global performance of one centre, in particular, for a population of reference. STUDY DESIGN: The validity of the TM was tested by a retrospective analysis all IVF/ICSI cycles (n = 12901) in our centre since 2000. PARTICIPANTS, SETTING AND METHODS: All IVF/ICSI cycles were included in the analysis. The model discrimination was evaluated by C-statistics, calculated as the area under the curve of an ROC curve. The TM was then adjusted for our data and additional variables were assessed. MAIN RESULTS AND THE ROLE OF CHANCE: Poor calibration and discrimination (C= 0.64) was observed in conformity with previous external validations. Fitting the TM to our centre constituted the first substantial improvement in prediction accuracy of discrimination (C = 0.69) and calibration. We identified an important linear time trend effect and the added value of three other predictors (FSH, smoking habits and BMI) that significantly improved the model (C = 0.71). BIAS, CONFOUNDING AND OTHER REASONS FOR CAUTION: Bias due to missing data handling was assessed through sensitivity analyses. GENERALIZABILITY TO OTHER POPULATIONS: Neither the TM nor any other models based on some centres are directly applicable to other centres. However, the TM constitutes a useful basis to build an accurate centre-specific model.
Affiliations:
- Australie, Belgique, France
- Région Bretagne, Victoria (État), Vienne (Autriche)
- Melbourne, Vienne (Autriche)
- Université de Melbourne
Links toward previous steps (curation, corpus...)
- to stream PascalFrancis, to step Corpus: 000E85
- to stream PascalFrancis, to step Curation: 005036
- to stream PascalFrancis, to step Checkpoint: 000D67
- to stream Main, to step Merge: 005C02
- to stream Main, to step Curation: 005917
Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en" level="a">Simple adaptations to the Templeton model for IVF outcome prediction make it current and clinically useful</title><author><name sortKey="Arvis, P" sort="Arvis, P" uniqKey="Arvis P" first="P." last="Arvis">P. Arvis</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Clinique la Sagesse, Place St Guénolé</s1><s2>Rennes 35000</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>35000</wicri:noRegion><wicri:noRegion>Place St Guénolé</wicri:noRegion><wicri:noRegion>Rennes 35000</wicri:noRegion></affiliation></author><author><name sortKey="Lehert, P" sort="Lehert, P" uniqKey="Lehert P" first="P." last="Lehert">P. Lehert</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Statistics Department, Faculty of Economics, University of Louvain, UCL Mons, 151 Chaussée de Binche</s1><s2>7000 Mons</s2><s3>BEL</s3><sZ>2 aut.</sZ></inist:fA14><country>Belgique</country><placeName><region type="land" nuts="2">Vienne (Autriche)</region><settlement type="city">Vienne (Autriche)</settlement></placeName></affiliation><affiliation wicri:level="4"><inist:fA14 i1="03"><s1>Faculty of Medicine, The University of Melbourne</s1><s2>Melbourne</s2><s3>AUS</s3><sZ>2 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region><settlement type="city">Melbourne</settlement></placeName><orgName type="university">Université de Melbourne</orgName></affiliation></author><author><name sortKey="Guivarc H Leveque, A" sort="Guivarc H Leveque, A" uniqKey="Guivarc H Leveque A" first="A." last="Guivarc'H-Leveque">A. Guivarc'H-Leveque</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Clinique la Sagesse, Place St Guénolé</s1><s2>Rennes 35000</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>35000</wicri:noRegion><wicri:noRegion>Place St Guénolé</wicri:noRegion><wicri:noRegion>Rennes 35000</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">12-0436393</idno><date when="2012">2012</date><idno type="stanalyst">PASCAL 12-0436393 INIST</idno><idno type="RBID">Pascal:12-0436393</idno><idno type="wicri:Area/PascalFrancis/Corpus">000E85</idno><idno type="wicri:Area/PascalFrancis/Curation">005036</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">000D67</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">000D67</idno><idno type="wicri:doubleKey">0268-1161:2012:Arvis P:simple:adaptations:to</idno><idno type="wicri:Area/Main/Merge">005C02</idno><idno type="wicri:Area/Main/Curation">005917</idno><idno type="wicri:Area/Main/Exploration">005917</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Simple adaptations to the Templeton model for IVF outcome prediction make it current and clinically useful</title><author><name sortKey="Arvis, P" sort="Arvis, P" uniqKey="Arvis P" first="P." last="Arvis">P. Arvis</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Clinique la Sagesse, Place St Guénolé</s1><s2>Rennes 35000</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region" nuts="2">Région Bretagne</region></placeName></affiliation></author><author><name sortKey="Lehert, P" sort="Lehert, P" uniqKey="Lehert P" first="P." last="Lehert">P. Lehert</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Statistics Department, Faculty of Economics, University of Louvain, UCL Mons, 151 Chaussée de Binche</s1><s2>7000 Mons</s2><s3>BEL</s3><sZ>2 aut.</sZ></inist:fA14><country>Belgique</country><placeName><region type="land" nuts="2">Vienne (Autriche)</region><settlement type="city">Vienne (Autriche)</settlement></placeName></affiliation><affiliation wicri:level="4"><inist:fA14 i1="03"><s1>Faculty of Medicine, The University of Melbourne</s1><s2>Melbourne</s2><s3>AUS</s3><sZ>2 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region><settlement type="city">Melbourne</settlement></placeName><orgName type="university">Université de Melbourne</orgName></affiliation></author><author><name sortKey="Guivarc H Leveque, A" sort="Guivarc H Leveque, A" uniqKey="Guivarc H Leveque A" first="A." last="Guivarc'H-Leveque">A. Guivarc'H-Leveque</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Clinique la Sagesse, Place St Guénolé</s1><s2>Rennes 35000</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>35000</wicri:noRegion><wicri:noRegion>Place St Guénolé</wicri:noRegion><wicri:noRegion>Rennes 35000</wicri:noRegion></affiliation></author></analytic><series><title level="j" type="main">Human reproduction : (Oxford. Print)</title><title level="j" type="abbreviated">Hum. reprod. : (Oxf., Print)</title><idno type="ISSN">0268-1161</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Human reproduction : (Oxford. Print)</title><title level="j" type="abbreviated">Hum. reprod. : (Oxf., Print)</title><idno type="ISSN">0268-1161</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adaptation</term><term>Birth</term><term>In vitro fertilization embryo transfer</term><term>Intracytoplasmic sperm injection</term><term>Mammalia</term><term>Models</term><term>Prediction</term><term>Prognosis</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Adaptation</term><term>Modèle</term><term>Fécondation in vitro transfert embryon</term><term>Pronostic</term><term>Prédiction</term><term>Naissance</term><term>Injection spermatozoïde intracytoplasmique</term><term>Mammalia</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">STUDY QUESTION: What is the validity of the Templeton model (TM) in predicting live birth (LB) for a couple starting an IVF/ICSI cycle? SUMMARY ANSWER: A centre-specific model based on the original predictors of the TM may reach a sufficient level of accuracy to be used in every day practice, with a few simple adaptations. WHAT IS KNOWN AND WHAT THIS PAPER ADDS: The TM seems the best predictive model of LB in IVF. However, previous validations of the TM suggest a lack of discrimination and calibration which means that it is not used in regular practice. We confirm this finding, and argue that such results are predictable, and essentially due to a strong centre effect. We provide evidence that the TM constitutes a useful reference reflecting a high proportion of the patient-mix effect since the parameters of the model remain invariant among centres, but also across various cultures, countries and types of hospitals. The only difference was the intercept value, interpreted as the measurement of the global performance of one centre, in particular, for a population of reference. STUDY DESIGN: The validity of the TM was tested by a retrospective analysis all IVF/ICSI cycles (n = 12901) in our centre since 2000. PARTICIPANTS, SETTING AND METHODS: All IVF/ICSI cycles were included in the analysis. The model discrimination was evaluated by C-statistics, calculated as the area under the curve of an ROC curve. The TM was then adjusted for our data and additional variables were assessed. MAIN RESULTS AND THE ROLE OF CHANCE: Poor calibration and discrimination (C= 0.64) was observed in conformity with previous external validations. Fitting the TM to our centre constituted the first substantial improvement in prediction accuracy of discrimination (C = 0.69) and calibration. We identified an important linear time trend effect and the added value of three other predictors (FSH, smoking habits and BMI) that significantly improved the model (C = 0.71). BIAS, CONFOUNDING AND OTHER REASONS FOR CAUTION: Bias due to missing data handling was assessed through sensitivity analyses. GENERALIZABILITY TO OTHER POPULATIONS: Neither the TM nor any other models based on some centres are directly applicable to other centres. However, the TM constitutes a useful basis to build an accurate centre-specific model.</div></front></TEI><affiliations><list><country><li>Australie</li><li>Belgique</li><li>France</li></country><region><li>Région Bretagne</li><li>Victoria (État)</li><li>Vienne (Autriche)</li></region><settlement><li>Melbourne</li><li>Vienne (Autriche)</li></settlement><orgName><li>Université de Melbourne</li></orgName></list><tree><country name="France"><region name="Région Bretagne"><name sortKey="Arvis, P" sort="Arvis, P" uniqKey="Arvis P" first="P." last="Arvis">P. Arvis</name></region><name sortKey="Guivarc H Leveque, A" sort="Guivarc H Leveque, A" uniqKey="Guivarc H Leveque A" first="A." last="Guivarc'H-Leveque">A. Guivarc'H-Leveque</name></country><country name="Belgique"><region name="Vienne (Autriche)"><name sortKey="Lehert, P" sort="Lehert, P" uniqKey="Lehert P" first="P." last="Lehert">P. Lehert</name></region></country><country name="Australie"><region name="Victoria (État)"><name sortKey="Lehert, P" sort="Lehert, P" uniqKey="Lehert P" first="P." last="Lehert">P. Lehert</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Asie/explor/AustralieFrV1/Data/Main/Exploration
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 005917 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd -nk 005917 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Asie
|area= AustralieFrV1
|flux= Main
|étape= Exploration
|type= RBID
|clé= Pascal:12-0436393
|texte= Simple adaptations to the Templeton model for IVF outcome prediction make it current and clinically useful
}}
| This area was generated with Dilib version V0.6.33. |  |