Validation, optimal threshold determination, and clinical utility of the infant risk of overweight checklist for early prevention of child overweight

Redsell, Sarah A. and Weng, Stephen and Swift, Judy A. and Nathan, Dilip and Glazebrook, Cris (2016) Validation, optimal threshold determination, and clinical utility of the infant risk of overweight checklist for early prevention of child overweight. Childhood Obesity, 12 (3). pp. 202-209. ISSN 2153-2176

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Abstract

Background: Previous research has demonstrated the predictive validity of the Infant Risk of Overweight Checklist (IROC). This study further establishes the predictive accuracy of the IROC using data from the Avon Longitudinal Study of Parents and Children (ALSPAC) and examines the optimal threshold for determining high risk of childhood overweight.

Methods: Using the IROC algorithm, we calculated the risk of being overweight, based on International Obesity Task Force criteria, in the first year of life for 980 children in the ALSPAC cohort at 5 years. Discrimination was assessed by the area under the receiver operating curve (AUC c-statistic). Net reclassification index (NRI) was calculated for risk thresholds ranging from 2.5% to 30%, which determine cutoffs for identifying infants at risk of becoming overweight.

Results: At 5 years of age, 12.3% of boys and 19.6% of girls were categorized overweight. Discrimination (AUC c-statistic) ranged from 0.67 (95% confidence interval [CI], 0.62–0.72) when risk scores were calculated directly to 0.93 (95% CI, 0.88–0.98) when the algorithm was recalibrated and missing values of the risk factor algorithm were imputed. The NRI showed that there were positive gains in reclassification using risk thresholds from 5% to 20%, with the maximum NRI being at 10%.

Conclusions: This study confirms that the IROC has moderately good validity for assessing overweight risk in infants and offers an optimal threshold for determining high risk. The IROC algorithm has been imbedded into a computer program for Proactive Assessment of Obesity Risk during Infancy, which facilitates early overweight prevention through communication of risk to parents.

Item Type: Article
Additional Information: Final publication is available from Mary Ann Liebert, Inc., publishers http://dx.doi.org/10.1089/chi.2015.0246
Schools/Departments: University of Nottingham UK Campus > Faculty of Medicine and Health Sciences > School of Medicine > Division of Psychiatry
University of Nottingham UK Campus > Faculty of Medicine and Health Sciences > School of Medicine > Division of Primary Care
University of Nottingham UK Campus > Faculty of Science
Identification Number: https://doi.org/10.1089/chi.2015.0246
Depositing User: Eprints, Support
Date Deposited: 25 May 2016 11:57
Last Modified: 17 Sep 2016 18:35
URI: http://eprints.nottingham.ac.uk/id/eprint/33479

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