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Modeling Fetal Weight for Gestational Age: A Comparison of a Flexible Multi-level Spline-based Model with Other Approaches

机译:妊娠期胎儿体重建模:基于柔性多级样条的模型与其他方法的比较

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摘要

We present a model for longitudinal measures of fetal weight as a function of gestational age. We use a linear mixed model, with a Box-Cox transformation of fetal weight values, and restricted cubic splines, in order to flexibly but parsimoniously model median fetal weight. We systematically compare our model to other proposed approaches. All proposed methods are shown to yield similar median estimates, as evidenced by overlapping pointwise confidence bands, except after 40 completed weeks, where our method seems to produce estimates more consistent with observed data. Sex-based stratification affects the estimates of the random effects variance-covariance structure, without significantly changing sex-specific fitted median values. We illustrate the benefits of including sex-gestational age interaction terms in the model over stratification. The comparison leads to the conclusion that the selection of a model for fetal weight for gestational age can be based on the specific goals and configuration of a given study without affecting the precision or value of median estimates for most gestational ages of interest.
机译:我们提出了作为胎龄函数的胎儿体重纵向测量模型。我们使用线性混合模型,对胎儿体重值进行Box-Cox变换,并使用受限三次样条曲线,以便灵活而简约地对中位数胎儿体重进行建模。我们系统地将我们的模型与其他提议的方法进行比较。所有建议的方法都显示出相似的中位数估计值,通过重叠的逐点置信带可以证明,除了40个完整的星期之后,我们的方法似乎得出的估计值与观察到的数据更加一致。基于性别的分层会影响随机效应方差-协方差结构的估计,而不会显着更改针对性别的拟合中值。我们说明了在模型中包括分层的性别-胎龄互动项的好处。比较得出的结论是,可以根据给定研究的特定目标和配置选择胎龄胎儿体重模型,而不会影响大多数目标胎龄的中位数估计值的准确性或价值。

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