Journal article
Quantile Score: A New Reference System for Quantitative Fetal Echocardiography Based on a Large Multicenter Study
Journal of the American Society of Echocardiography, v 32(2), pp 296-302
Feb 2019
PMID: 30591282
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Normative ranges of fetal echocardiographic measurements are important for quantitative diagnosis of fetal cardiovascular disease. The current normative ranges were derived from small samples and were based on the hypothesis of a normal distribution of these measurements during fetal cardiovascular growth. The aims of this study were to test the hypothesis of a normal distribution of fetal echocardiographic measurements in a large multicenter cohort and to propose a reference system without the normal distribution hypothesis to improve accuracy of fetal echocardiographic measurements.
Fifty-two variables from 6,343 normal fetal echocardiographic examinations were acquired from seven Chinese centers. The hypothesis of a normal distribution used in ordinary least squares regression was tested with the Jarque-Bera test. The quantile score (q score) derived from quantile regression without normal distribution hypothesis was compared with the Z score derived from ordinary least squares regression. A total of 288 fetuses with outflow tract and great artery abnormalities and 300 normal fetuses were used to compare the diagnostic accuracy of q and Z scores.
All fetal echocardiographic measurements showed non-normal distributions (P < .001). The normal range was underestimated by ordinary least squares regression compared with quantile regression by 30 ± 11%. The partial normalized areas under the receiver operating characteristic curve within the 20% false-positive rate were 0.62 and 0.50 for the q and Z scores, respectively.
The q score provides a more robust system for determining normative ranges of fetal echocardiographic measurements. The improved sensitivity of matched false-positive rates makes the q score a more accurate reference for prenatal diagnosis, assessment, and prognosis of fetal cardiovascular disease.
•The fetal echocardiographic measurements are not normally distributed.•The current Z score for fetal echocardiographic measurements is underestimated.•The q score provides a more accurate for normative ranges.•Future studies in different ethnic groups and automated algorithms are warranted.
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Details
- Title
- Quantile Score: A New Reference System for Quantitative Fetal Echocardiography Based on a Large Multicenter Study
- Creators
- Xiaoyan Gu - Beijing Anzhen HospitalHaogang Zhu - Beihang UniversityYe Zhang - Department of Ultrasound, Beijing Anzhen Hospital, Capital Medical University, Beijing, ChinaJiancheng Han - Beijing Anzhen HospitalHongjia Zhang - Beijing Anzhen HospitalYing Liu - Linzi District People's HospitalAirong Wang - Department of Ultrasound, Tongzhou Maternal & Child Health Hospital, Tongzhou, China.Baomin Liu - Second Affiliated Hospital of Xi'an Jiaotong UniversityJun Xue - Meitan General HospitalBaojuan Sun - Yangzhou UniversityZongjie Weng - Fujian Medical UniversityShuping Ge - St. Christopher's Hospital for ChildrenYihua He - Beijing Anzhen Hospital
- Publication Details
- Journal of the American Society of Echocardiography, v 32(2), pp 296-302
- Publisher
- Elsevier
- Grant note
- Z151100003915142 / Beijing municipal science & technology commission reform and development programs 2015-3-409 / Cultivation of high level health technical personnel in Beijing health system XMLX201604 / Beijing Municipal Administration of Hospitals Clinical medicine Development of special funding support (https://doi.org/10.13039/501100009331) 116211 / Beijing Laboratory for Cardiovascular Precision Medicine BZ0308 / Beijing Key Laboratory of Maternal-Fetal Medicine in fetal heart disease 61702027 / National Natural Science Foundation of China (https://doi.org/10.13039/501100001809) BJMSJY-160153 / Beijing Municipal Science and Technology Commission (https://doi.org/10.13039/501100009592)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Pediatrics
- Web of Science ID
- WOS:000457632100012
- Scopus ID
- 2-s2.0-85058974979
- Other Identifier
- 991019167706104721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Cardiac & Cardiovascular Systems