Development and external validation of a home-based risk predicTion modEl of natUral onseT of menopAuse -TEUTA

Lum Kastrati; Pedro Marques Vidal; Klodian Dhana; Lia Bally; Irene Lambrinoudaki; Dion Groothof; Stephan J L Bakker; Michele F Eisenga; Taulant Muka

doi:10.1210/clinem/dgae125

Development and external validation of a home-based risk predicTion modEl of natUral onseT of menopAuse -TEUTA

J Clin Endocrinol Metab. 2024 Mar 5:dgae125. doi: 10.1210/clinem/dgae125. Online ahead of print.

Authors

Lum Kastrati^{1

2

3}, Pedro Marques Vidal⁴, Klodian Dhana⁵, Lia Bally³, Irene Lambrinoudaki⁶, Dion Groothof⁷, Stephan J L Bakker⁷, Michele F Eisenga⁷, Taulant Muka^{8

9}

Affiliations

¹ Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.
² Graduate School for Health Sciences, University of Bern, Bern, Switzerland.
³ Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Inselspital, Bern University Hospital, University of Bern, Switzerland.
⁴ Department of Medicine, internal medicine, Lausanne university hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.
⁵ Department of Internal Medicine, Rush University Medical Center, Chicago, IL.
⁶ National and Kapodistrian University of Athens, 2nd Department of Obstetrics and Gynecology, Athens, Greece.
⁷ Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, the Netherlands.
⁸ Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, California, USA.
⁹ Epistudia, 3011 Bern, Switzerland.

PMID: 38442740
DOI: 10.1210/clinem/dgae125

Abstract

Objective: To develop and externally validate a 10-year risk prediction model of natural onset of menopause using ready-to-use predictors.

Design: Population-based prospective cohort study.

Participants: Community-dwelling, premenopausal women aged 28 years and older enrolled in the Swiss (CoLaus) and Dutch (PREVEND) study.

Main outcome measure: Incidence of self-reported natural menopause.

Model development: Based on existing literature, 11 predictors were tested in this study. The CoLaus cohort was used to develop the model by applying the backward-elimination approach and Bayesian Model Averaging. Internal validation was performed by bootstrapping. External validation was performed using data from the PREVEND cohort and recalibrating the baseline survival estimate. C-statistic, calibration slopes, and expected/observed probabilities were calculated as measures of model internal and/or external performances.

Results: The final analysis included 750 and 1032 premenopausal women from the CoLaus and the PREVEND cohort, respectively. Among them, 445 (59%) from CoLaus and 387 (38%) from PREVEND experienced menopause over a median follow-up of 10.7 and 9 years, respectively. The final model included age, alcohol consumption, smoking status, education level, and systolic blood pressure. Upon external calibration in the PREVEND cohort, the model exhibited good discrimination, with a C-statistic of 0.888 and an expected/observed probability of 0.82.

Conclusions: We present the first internally and externally validated prediction model of natural menopause onset using readily available predictors. Validation of our model to other populations is needed.

Keywords: Family Planning; Menopause; Prediction; Validation.