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Update and, internal and temporal-validation of the FRANCE-2 and ACC-TAVI early-mortality prediction models for Transcatheter Aortic Valve Implantation (TAVI) using data from the Netherlands heart registration (NHR)
BACKGROUND: The predictive performance of the models FRANCE-2 and ACC-TAVI for early-mortality after Transcatheter Aortic Valve Implantation (TAVI) can decline over time and can be enhanced by updating them on new populations. We aim to update and internally and temporally validate these models usin...
Autores principales: | , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7843396/ https://www.ncbi.nlm.nih.gov/pubmed/33537406 http://dx.doi.org/10.1016/j.ijcha.2021.100716 |
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author | Al-Farra, Hatem de Mol, Bas A.J.M. Ravelli, Anita C.J. ter Burg, W.J.P.P. Houterman, Saskia Henriques, José P.S. Abu-Hanna, Ameen Vis, M.M. Vos, J. Timmers, L. Tonino, W.A.L. Schotborgh, C.E. Roolvink, V. Porta, F. Stoel, M.G. Kats, S. Amoroso, G. van der Werf, H.W. Stella, P.R. de Jaegere, P. |
author_facet | Al-Farra, Hatem de Mol, Bas A.J.M. Ravelli, Anita C.J. ter Burg, W.J.P.P. Houterman, Saskia Henriques, José P.S. Abu-Hanna, Ameen Vis, M.M. Vos, J. Timmers, L. Tonino, W.A.L. Schotborgh, C.E. Roolvink, V. Porta, F. Stoel, M.G. Kats, S. Amoroso, G. van der Werf, H.W. Stella, P.R. de Jaegere, P. |
author_sort | Al-Farra, Hatem |
collection | PubMed |
description | BACKGROUND: The predictive performance of the models FRANCE-2 and ACC-TAVI for early-mortality after Transcatheter Aortic Valve Implantation (TAVI) can decline over time and can be enhanced by updating them on new populations. We aim to update and internally and temporally validate these models using a recent TAVI-cohort from the Netherlands Heart Registration (NHR). METHODS: We used data of TAVI-patients treated in 2013–2017. For each original-model, the best update-method (model-intercept, model-recalibration, or model-revision) was selected by a closed-testing procedure. We internally validated both updated models with 1000 bootstrap samples. We also updated the models on the 2013–2016 dataset and temporally validated them on the 2017-dataset. Performance measures were the Area-Under ROC-curve (AU-ROC), Brier-score, and calibration graphs. RESULTS: We included 6177 TAVI-patients, with 4.5% observed early-mortality. The selected update-method for FRANCE-2 was model-intercept-update. Internal validation showed an AU-ROC of 0.63 (95%CI 0.62–0.66) and Brier-score of 0.04 (0.04–0.05). Calibration graphs show that it overestimates early-mortality. In temporal-validation, the AU-ROC was 0.61 (0.53–0.67). The selected update-method for ACC-TAVI was model-revision. In internal-validation, the AU-ROC was 0.63 (0.63–0.66) and Brier-score was 0.04 (0.04–0.05). The updated ACC-TAVI calibrates well up to a probability of 20%, and subsequently underestimates early-mortality. In temporal-validation the AU-ROC was 0.65 (0.58–0.72). CONCLUSION: Internal-validation of the updated models FRANCE-2 and ACC-TAVI with data from the NHR demonstrated improved performance, which was better than in external-validation studies and comparable to the original studies. In temporal-validation, ACC-TAVI outperformed FRANCE-2 because it suffered less from changes over time. |
format | Online Article Text |
id | pubmed-7843396 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-78433962021-02-02 Update and, internal and temporal-validation of the FRANCE-2 and ACC-TAVI early-mortality prediction models for Transcatheter Aortic Valve Implantation (TAVI) using data from the Netherlands heart registration (NHR) Al-Farra, Hatem de Mol, Bas A.J.M. Ravelli, Anita C.J. ter Burg, W.J.P.P. Houterman, Saskia Henriques, José P.S. Abu-Hanna, Ameen Vis, M.M. Vos, J. Timmers, L. Tonino, W.A.L. Schotborgh, C.E. Roolvink, V. Porta, F. Stoel, M.G. Kats, S. Amoroso, G. van der Werf, H.W. Stella, P.R. de Jaegere, P. Int J Cardiol Heart Vasc Original Paper BACKGROUND: The predictive performance of the models FRANCE-2 and ACC-TAVI for early-mortality after Transcatheter Aortic Valve Implantation (TAVI) can decline over time and can be enhanced by updating them on new populations. We aim to update and internally and temporally validate these models using a recent TAVI-cohort from the Netherlands Heart Registration (NHR). METHODS: We used data of TAVI-patients treated in 2013–2017. For each original-model, the best update-method (model-intercept, model-recalibration, or model-revision) was selected by a closed-testing procedure. We internally validated both updated models with 1000 bootstrap samples. We also updated the models on the 2013–2016 dataset and temporally validated them on the 2017-dataset. Performance measures were the Area-Under ROC-curve (AU-ROC), Brier-score, and calibration graphs. RESULTS: We included 6177 TAVI-patients, with 4.5% observed early-mortality. The selected update-method for FRANCE-2 was model-intercept-update. Internal validation showed an AU-ROC of 0.63 (95%CI 0.62–0.66) and Brier-score of 0.04 (0.04–0.05). Calibration graphs show that it overestimates early-mortality. In temporal-validation, the AU-ROC was 0.61 (0.53–0.67). The selected update-method for ACC-TAVI was model-revision. In internal-validation, the AU-ROC was 0.63 (0.63–0.66) and Brier-score was 0.04 (0.04–0.05). The updated ACC-TAVI calibrates well up to a probability of 20%, and subsequently underestimates early-mortality. In temporal-validation the AU-ROC was 0.65 (0.58–0.72). CONCLUSION: Internal-validation of the updated models FRANCE-2 and ACC-TAVI with data from the NHR demonstrated improved performance, which was better than in external-validation studies and comparable to the original studies. In temporal-validation, ACC-TAVI outperformed FRANCE-2 because it suffered less from changes over time. Elsevier 2021-01-23 /pmc/articles/PMC7843396/ /pubmed/33537406 http://dx.doi.org/10.1016/j.ijcha.2021.100716 Text en © 2021 The Author(s) http://creativecommons.org/licenses/by/4.0/ This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Original Paper Al-Farra, Hatem de Mol, Bas A.J.M. Ravelli, Anita C.J. ter Burg, W.J.P.P. Houterman, Saskia Henriques, José P.S. Abu-Hanna, Ameen Vis, M.M. Vos, J. Timmers, L. Tonino, W.A.L. Schotborgh, C.E. Roolvink, V. Porta, F. Stoel, M.G. Kats, S. Amoroso, G. van der Werf, H.W. Stella, P.R. de Jaegere, P. Update and, internal and temporal-validation of the FRANCE-2 and ACC-TAVI early-mortality prediction models for Transcatheter Aortic Valve Implantation (TAVI) using data from the Netherlands heart registration (NHR) |
title | Update and, internal and temporal-validation of the FRANCE-2 and ACC-TAVI early-mortality prediction models for Transcatheter Aortic Valve Implantation (TAVI) using data from the Netherlands heart registration (NHR) |
title_full | Update and, internal and temporal-validation of the FRANCE-2 and ACC-TAVI early-mortality prediction models for Transcatheter Aortic Valve Implantation (TAVI) using data from the Netherlands heart registration (NHR) |
title_fullStr | Update and, internal and temporal-validation of the FRANCE-2 and ACC-TAVI early-mortality prediction models for Transcatheter Aortic Valve Implantation (TAVI) using data from the Netherlands heart registration (NHR) |
title_full_unstemmed | Update and, internal and temporal-validation of the FRANCE-2 and ACC-TAVI early-mortality prediction models for Transcatheter Aortic Valve Implantation (TAVI) using data from the Netherlands heart registration (NHR) |
title_short | Update and, internal and temporal-validation of the FRANCE-2 and ACC-TAVI early-mortality prediction models for Transcatheter Aortic Valve Implantation (TAVI) using data from the Netherlands heart registration (NHR) |
title_sort | update and, internal and temporal-validation of the france-2 and acc-tavi early-mortality prediction models for transcatheter aortic valve implantation (tavi) using data from the netherlands heart registration (nhr) |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7843396/ https://www.ncbi.nlm.nih.gov/pubmed/33537406 http://dx.doi.org/10.1016/j.ijcha.2021.100716 |
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