Comment on “Accuracy of the FMF Bayes theorem-based model for predicting preeclampsia at 11–13 weeks of gestation in a Japanese population”

In Goto’s paper, the prediction model essentially revealed a 46 good degree of reproducibility in terms of detection rate (DR) 47 compared with the original results already shown by other 48 local and independent studies and obtained mainly in Eur- 49 opean populations (Caucasian in the vast majority of studies). 50 In particular, the DR for preterm PE at a fixed 10% false 51 positive rate (FPR) was 91% when all the available markers 52 (maternal factors, mean arterial pressure (MAP), uterine artery 53 pulsatility index (UtA-PI) and placental growth factor (PlGF)) 54 were included in the model. On the other hand, the prediction 55 for term PE was poorer with 60% DR at a fixed FPR of 10%. 56 The calibration curve for early PE (expected vs. observed 57 risk) was basically in line with the original estimation [2, 3]. 58 In fact, in a calibration plot, the very high expected and 59 observed risks (1:1–1:10) were quite similar, but a less correct 60 calibration (with underestimation of the validation model) was 61 obtained for the observed value. In fact, for an estimation of 62 1:600, the corresponding expected risk value was ~1:90. It is 63 unclear whether this abnormal calibration could affect DR 64 and/or FPR.