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Validation, optimal threshold determination, and clinical utility of the Infant Risk of Overweight Checklist (IROC) for early prevention of child overweight

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posted on 2023-08-30, 14:15 authored by Sarah A. Redsell, Stephen F. Weng, Judy A. Swift, Dilip Nathan, Cris Glazebrook
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 (IOTF) 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 cut-offs for identifying infants at risk of becoming overweight. Results: At five years of age, 12.3% of boys and 19.6% of girls were categorised overweight. Discrimination (AUC c-statistic) ranged from 0.67 (95% 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 there were positive gains in reclassification using risk thresholds from 5% to 20%, with the maximum NRI being at 10%. Conclusions: This study confirms 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 programme for Proactive Assessment of Obesity Risk during Infancy (ProAsk) which facilitates early overweight prevention through communication of risk to parents. http://online.liebertpub.com/doi/full/10.1089/chi.2015.0246

History

Refereed

  • Yes

Volume

12

Issue number

3

Page range

202-209

Publication title

Childhood Obesity

ISSN

2153-2176

Publisher

Mary Ann Liebert

File version

  • Accepted version

Language

  • eng

Legacy posted date

2016-04-25

Legacy creation date

2016-08-23

Legacy Faculty/School/Department

ARCHIVED Faculty of Health, Social Care & Education (until September 2018)

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