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February 2019 (vol. 220, no. 2, pages 199.e1-13)

    Published:April 19, 2019DOI:https://doi.org/10.1016/j.ajog.2019.04.008
        Wright D, Tan MY, O’Gorman N, et al. Predictive performance of the competing risk model in screening for preeclampsia. Am J Obstet Gynecol 2019;220:199.e1-13.
        In an original research article published in the February 2019 issue of the Journal, the full name of a 2016 National Health Service cohort study conducted in 7 maternity hospitals in England was spelled out incorrectly. The correct name of the study, abbreviated “SPREE,” is Screening Program for Preeclampsia, not, as published, Superior Province Rifting EarthScope Experiment.
        The incorrect full name of the study appears once in the text (column 3, page 199.e2) and is repeated in column headings, section identification, keys, and/or labels in Tables 1 and 2 (pages 199.e3 and 199.e4), Figure 1 (page 199.e5), and online-only Supplemental Figures 1, 2, and 3 (pages 199.e10, 199.e11, and 199.e12). The abbreviation is used as a label in graphs, but is not spelled out, in Figure 2 and in online-only Supplemental Figures 4, 5, and 6.
        In addition, 2 items under “Author and article information” (page 199.e9) require amplification.
        First, to the published academic affiliation of the fourth-named author, Liona C. Poon, MD, the following should be appended: “Department of Obstetrics and Gynecology, The Chinese University of Hong Kong, Hong Kong, People’s Republic of China.”
        Second, a full description of support for the study reads as follows:
        “This study was supported by grants from the National Institute for Health Research Efficacy and Mechanism Evaluation (NIHR EME) Program (14/01/02), an MRC–NIHR partnership; the Fetal Medicine Foundation (UK Charity No. 1037116); and NIHR Collaboration for Leadership in Applied Health Research and Care South London at King’s College Hospital NHS Foundation Trust, London, UK. The views expressed are the authors’ and do not necessarily reflect those of the MRC, NHS, NIHR, or Department of Health.
        “Reagents and equipment for the measurement of serum placental growth factor were provided gratis by PerkinElmer Life and Analytical Sciences and Thermo Fisher Scientific, both in Waltham, MA, which were not involved in the study design; the collection, analysis, or interpretation of data; the writing of the report; or the decision to submit the article for publication.”

        Linked Article

        • Predictive performance of the competing risk model in screening for preeclampsia
          American Journal of Obstetrics & GynecologyVol. 220Issue 2
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            The established method of screening for preeclampsia is to identify risk factors from maternal demographic characteristics and medical history; in the presence of such factors the patient is classified as high risk and in their absence as low risk. However, the performance of such an approach is poor. We developed a competing risks model, which allows combination of maternal factors (age, weight, height, race, parity, personal and family history of preeclampsia, chronic hypertension, diabetes mellitus, systemic lupus erythematosus or antiphospholipid syndrome, method of conception and interpregnancy interval), with biomarkers to estimate the individual patient-specific risks of preeclampsia requiring delivery before any specified gestation.
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        • Incorporating the probability of competing event(s) into the preeclampsia competing risk algorithm
          American Journal of Obstetrics & GynecologyVol. 221Issue 5
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            We read with great interest the paper by Wright et al1 in which the authors assessed the predictive performance of their competing risk algorithm for preeclampsia. Using such an approach, the authors estimated the detection rate for early, preterm, and all preeclampsia to be 90%, 75%, and 50%, respectively. The authors are to be congratulated for introducing the important concept of survival analysis and competing risks into this emerging field of prenatal care. However, further refinement of the algorithm is warranted.
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          American Journal of Obstetrics & GynecologyVol. 221Issue 5
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            The risks produced from our competing risks model1 are for delivery with preeclampsia before a specific gestational age, assuming no other cause for delivery. Because other-cause deliveries are effectively censored observations, the actual incidence of preeclampsia would be expected to be lower than predicted. For early gestations, when there are few other-cause deliveries, the effects would be small. At later gestations, with many other-cause deliveries, the effect of censoring may be substantial.
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