Combining probability scores to optimize clinical use of the NICHD Neonatal BPD Outcome Estimator

Abstract

Objective: Bronchopulmonary dysplasia (BPD) continues to prevail among very preterm infants. While NICHD BPD Outcome Estimator is easy to use, the clinical interpretation remains challenging. This study aims to optimize its use. Study Design: A retrospective study was conducted with 469 infants born between 2015 and 2020. Data were entered into the Estimator to obtain probability scores. Trajectories of the probability scores were modeled using generalized additive modeling. The optimal cutoff number for predicting severe BPD or death was identified by a grid search from a range established by the original population distribution and the ROC curve. Result: Combining probability scores from the severe and death categories and the no-BPD and mild categories may improve BPD outcome prediction. A cutoff of 21% combining outcome probabilities from severe and death categories is predictive of severe BPD or death. Conclusion: Combining probability scores of different categories improves BPD outcome prediction.