Applying the Newman-Peacock Prognostic System to a Portuguese Obstetrical Population - A Useful Tool?

Abstract

The Newman-Peacock score had a poorer performance among our population compared to its performance in the original study, but the results suggest that this score is still a useful tool to guide our clinical practice and counsel the candidate regarding ECV.

Prediction Models for Successful External Cephalic Version: An Updated Systematic Review

“…Of the 17 new articles, 4 had some form of overlap with articles from the prior systematic review (Figure 2). Two 25,26 were external validation studies of a 1993 prediction model 27 in a new population by a new investigational team; one of the validation studies also described a new model 26 . A third article 28 had a partially overlapping dataset with the investigational team's prior articles 22,23 , but proposed a model for predicting delivery type, while the prior articles focused on predicting cephalic presentation immediately after ECV.…”

“…The results of the study quality assessment based on the signaling questions are shown in Table 4. Out of 17 new articles, 10 studies were identi ed as having low overall risk of bias and high study quality 22,[29][30][31][32]35,37,[40][41][42] , 6 studies were identi ed as having moderate bias and moderate study quality 25,33,34,38,39,43 , and 1 was considered to have high bias and low quality 26 . This is in addition to Velzel et al's assessment of the 8 prior articles of which 4 were low risk of bias and high study quality and 4 were moderate risk of bias and study quality 10 .…”

“…Lin et al's model had temporal external validation; additionally, the ECV operator was not restricted during validation 35 . The Newman-Peacock model was proposed and temporally validated by an American team in 1993 27 and was externally validated by independent teams in Pakistan and Portugal in 2012 and 2018 respectively 25,26 . With the exception of this model, no other articles had external validation in another hospital system or by another investigational team, and no other models had a second external validation study.…”

“…Those articles that reported some form of calibration metric all reported good calibration, except Dong et al which reported good calibration for their ECV success model but not the delivery outcome model 32 . The Newman-Peacock model is the only model that passed external validation in a new location or by another investigator team; neither the original article nor that by the new team reported calibration metrics although the odds of success by score group were reported (Table 7) 25,27 . Some metrics for model discrimination (e.g., sensitivity, AUC, accuracy, PPV) was displayed in 17 of the 25 models.…”

Prediction Models for Successful External Cephalic Version: An Updated Systematic Review

“…Of the 17 new articles, 4 had some form of overlap with articles from the prior systematic review (Figure 2). Two 29,30 were external validation studies of a 1993 prediction model 31 in a new population by a new investigational team; one of the validation studies also described a new model 30 . A third article 32 had a partially overlapping dataset with the investigational team's prior articles 22,23 , but proposed a model for predicting delivery type, while the prior articles focused on predicting cephalic presentation immediately after ECV.…”