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4. Added value of ovarian reserve testing on patient characteristics in the prediction of ovarian response and ongoing pregnancy: an individual patient data approach

Author

Broer, Simone L., van Disseldorp, Jeroen, Broeze, Kimiko A., Dolleman, Madeleine, Opmeer, Brent C., Bossuyt, Patrick, Eijkemans, Marinus J.C., Mol, Ben-Willem J., Broekmans, Frank J.M., Broer, S.L., van Disseldorp, J., Broeze, K.A., Dolleman, M., Opmeer, B.C., Anderson, R.A., Ashrafi, M., Bancsi, L., Caroppo, L. E., Copperman, A., Ebner, T., Eldar Geva, M., Erdem, M., Greenblatt, E.M., Jayaprakasan, K., Fenning, Raine, Klinkert, E.R., Kwee, J., Lambalk, C.B., La Marca, A., McIlveen, M., Merce, L.T., Muttukrishna, S., Nelson, S.M., Ng, H.Y., Popovic-Todorovic, B., Smeenk, J.M.J., Tomás, C., Van der Linden, P.J.Q., van Rooij, I.A., Vladimirov, I.K., Bossuyt, P.B., Eijkemans, M.J.C., Mol, B.W., and Frank, Broekmans

Published
2013
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5. Added value of ovarian reserve testing on patient characteristics in the prediction of ovarian response and ongoing pregnancy: an individual patient data approach

Author

Greenblatt, E. M., Smeenk, J. M. J., Mol, B. W., Broekmans, Frank, Ebner, T., Ng, H. Y., Broer, Simone L., van Disseldorp, Jeroen, Broeze, Kimiko A., Merce, L. T., Bossuyt, Patrick, Opmeer, Brent C., Mol, Ben-Willem J., Broekmans, Frank J. M., Van der Linden, P. J. Q., Copperman, A., Geva, Eldar M., van Rooij, I. A., Erdem, M., McIlveen, M., Tomas, C., La Marca, A., Eijkemans, Marinus J. C., Vladimirov, I. K., Popovic-Todorovic, B., Lambalk, C. B., Bossuyt, P. B., Caroppo, E., Bancsi, L., Ashrafi, M., Kwee, J., Eijkemans, M. J. C., Dolleman, Madeleine, Klinkert, E. R., Nelson, S. M., Fenning, Raine, Jayaprakasan, K., Anderson, R. A., Muttukrishna, S., Obstetrics and gynaecology, ICaR - Ischemia and repair, NCA - Brain mechanisms in health and disease, Other departments, Clinical Research Unit, APH - Amsterdam Public Health, Epidemiology and Data Science, 10 Public Health & Methodologie, and Obstetrics and Gynaecology

Subjects
Anti-Mullerian Hormone, medicine.medical_specialty, Ovarian reserve tests, Individual patient data meta-analysis, Cell Count, Fertilization in Vitro, Logistic regression, Ovarian Follicle, Obstetrics and gynaecology, Predictive Value of Tests, Pregnancy, medicine, AMH, Humans, Ovarian reserve, reproductive and urinary physiology, Gynecology, biology, urogenital system, business.industry, Obstetrics, Ovary, Obstetrics and Gynecology, Anti-Müllerian hormone, Prognosis, Antral follicle, medicine.disease, female genital diseases and pregnancy complications, AFC, ROC Curve, Human Reproduction Renal disorder [NCEBP 12], Reproductive Medicine, Meta-analysis, Predictive value of tests, IVF outcome prediction, biology.protein, Ovulation Prediction, Female, Follicle Stimulating Hormone, business, therapeutics, hormones, hormone substitutes, and hormone antagonists
Abstract

Item does not contain fulltext BACKGROUND Although ovarian reserve tests (ORTs) are frequently used prior to IVF treatment for outcome prediction, their added predictive value is unclear. We assessed the added value of ORTs to patient characteristics in the prediction of IVF outcome. METHODS An individual patient data (IPD) meta-analysis from published studies was performed. Studies on FSH, anti-Mullerian hormone (AMH) or antral follicle count (AFC) in women undergoing IVF were identified and authors were contacted. Using random intercept logistic regression models, we estimated the added predictive value of ORTs for poor response and ongoing pregnancy after IVF, relative to patient characteristics. RESULTS We were able to collect 28 study databases, comprising 5705 women undergoing IVF. The area under the receiver-operating characteristic curve (AUC) for female age in predicting poor response was 0.61. AFC and AMH each significantly improved the model fit (P-value

Published
2013

6. Using individual patient data to adjust for indirectness did not successfully remove the bias in this case of comparative test accuracy.

Author

Junfeng Wang, Bossuyt, Patrick, Geskus, Ronald, Zwinderman, Aeilko, Dolleman, Madeleine, Broer, Simone, Broekmans, Frank, Mol, Ben Willem, and Leeflang, Mariska

Subjects
*SOMATOSTATIN, *SYSTEMATIC reviews, *DATA analysis, *MEDICAL research, *COMPARATIVE studies
Abstract

Objectives: In comparative systematic reviews of diagnostic accuracy, inconsistencies between direct and indirect comparisons may lead to bias. We investigated whether using individual patient data (IPD) can adjust for this form of bias. Study Design and Setting: We included IPD of 3 ovarian reserve tests from 32 studies. Inconsistency was defined as a statistically significant difference in relative accuracy or different comparative results between the direct and indirect evidence. We adjusted for the effect of threshold and reference standard, as well as for patient-specific variables. Results: Anti-Müllerian hormone (AMH) and follicle stimulation hormone (FSH) differed significantly in sensitivity (-0.1563, P = 0.04). AMH and antral follicle count (AFC) differed significantly in sensitivity (0.1465, P < 0.01). AMH and AFC differed significantly in specificity (-0.0607, P = 0.02). The area under the curve (AUC) differed significantly between AFC and FSH (0.0948, P < 0.01) in the direct comparison but not (0.0678, P = 0.09) in the indirect comparison. The AUCs of AFC and AMH differed significantly (-0.0830, P < 0.01) in the indirect comparison but not (-0.0176, P = 0.29) in the direct comparison. These differences remained after adjusting for indirectness. Conclusion: Estimates of comparative accuracy obtained through indirect comparisons are not always consistent with those obtained through direct comparisons. Using IPD to adjust for indirectness did not successfully remove the bias in this case study. [ABSTRACT FROM AUTHOR]

Published
2015
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