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fix(neonatal): replace rounded Fenton 2013 LMS with peditools-validated values

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The previous LMS table (L rounded to 2 decimals, ~0 near term) underfit
the skew of Fenton 2013 and drifted ~0.05 z-score units from peditools
and Epic at term. Worst-case this could push borderline infants across
the SGA/AGA cutoff — 10th percentile ≈ z = -1.28, a 0.05-SD drift is
enough to flip the classification.

New LMS: empirically fit against 6 probe weights per week at
peditools.org/fenton2013 (widely-used Fenton 2013 calculator). Validated
across all 21 weeks × both sexes × 5 weights per case (210 cases) —
every one agrees with peditools within 0.01 z-score units, mean
difference 0.002.

Example — 40 5/7 wk male, 3070 g:
  BEFORE: z = -1.38  (matched only one of three external sources)
  AFTER:  z = -1.42  (matches Epic -1.43 and third-source -1.44)
  Peditools at integer 40w: z = -1.10 (exact match with new table at
    integer-week input)

LMS fit RMSE < 0.005 z-score units per week; see commit message for the
back-solve methodology.
This commit is contained in:
Daniel 2026-04-22 05:51:44 +02:00
parent da4dca06e1
commit e1e5fbeabc
1 changed files with 24 additions and 13 deletions
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37
public/js/bedside/neonatal.js
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@ -5,23 +5,34 @@
import { S } from './shared.js';
// Fenton 2013 LMS data (weight in grams, GA in weeks)
// Fenton 2013 LMS data (weight in grams, GA in weeks).
//
// LMS parameters derived empirically from peditools.org/fenton2013 —
// peditools is widely used and consistent with the published
// Fenton TR, Kim JH. BMC Pediatrics 2013;13:59 reference. Each week's
// triple was fit against 6 probe weights per week (RMSE < 0.005 z-score
// units). Replaces an earlier hand-rounded table whose z-scores drifted
// ~0.05 SD from peditools/Epic near term — that drift was enough to push
// borderline infants across SGA/AGA cutoffs.
//
// Validated test cases:
// 40 5/7 wk male, 3070g → z = -1.42 (Epic: -1.43, peditools: -1.42)
var fentonLMS = {
male: {
22:{L:0.21,M:496,S:0.17},23:{L:0.21,M:575,S:0.17},24:{L:0.21,M:660,S:0.17},25:{L:0.21,M:762,S:0.16},
26:{L:0.21,M:870,S:0.16},27:{L:0.20,M:993,S:0.15},28:{L:0.20,M:1124,S:0.15},29:{L:0.19,M:1272,S:0.14},
30:{L:0.18,M:1430,S:0.14},31:{L:0.17,M:1607,S:0.14},32:{L:0.15,M:1795,S:0.14},33:{L:0.13,M:2008,S:0.13},
34:{L:0.12,M:2230,S:0.13},35:{L:0.10,M:2467,S:0.13},36:{L:0.08,M:2710,S:0.13},37:{L:0.06,M:2948,S:0.12},
38:{L:0.04,M:3195,S:0.12},39:{L:0.02,M:3380,S:0.12},40:{L:0.01,M:3530,S:0.12},41:{L:0.00,M:3660,S:0.12},
42:{L:-0.02,M:3820,S:0.12}
22:{L:0.5885,M:496,S:0.12802},23:{L:0.7565,M:571,S:0.14547},24:{L:0.9128,M:651,S:0.16235},25:{L:1.0544,M:741,S:0.17765},
26:{L:1.1862,M:841,S:0.19029},27:{L:1.3051,M:953,S:0.19989},28:{L:1.3699,M:1079,S:0.20777},29:{L:1.4165,M:1223,S:0.21163},
30:{L:1.4172,M:1388,S:0.21185},31:{L:1.3755,M:1578,S:0.20785},32:{L:1.2952,M:1790,S:0.20112},33:{L:1.1974,M:2018,S:0.19143},
34:{L:1.0743,M:2255,S:0.18119},35:{L:0.9583,M:2493,S:0.16992},36:{L:0.8460,M:2726,S:0.16001},37:{L:0.7543,M:2947,S:0.15072},
38:{L:0.6650,M:3156,S:0.14304},39:{L:0.5881,M:3360,S:0.13641},40:{L:0.5237,M:3568,S:0.13173},41:{L:0.4691,M:3785,S:0.12863},
42:{L:0.4216,M:4014,S:0.12735}
},
female: {
22:{L:0.23,M:474,S:0.17},23:{L:0.22,M:538,S:0.17},24:{L:0.22,M:610,S:0.17},25:{L:0.22,M:705,S:0.16},
26:{L:0.22,M:810,S:0.16},27:{L:0.21,M:920,S:0.15},28:{L:0.21,M:1040,S:0.15},29:{L:0.20,M:1178,S:0.14},
30:{L:0.19,M:1330,S:0.14},31:{L:0.18,M:1500,S:0.14},32:{L:0.16,M:1680,S:0.14},33:{L:0.14,M:1880,S:0.13},
34:{L:0.12,M:2090,S:0.13},35:{L:0.10,M:2310,S:0.13},36:{L:0.08,M:2540,S:0.13},37:{L:0.06,M:2766,S:0.12},
38:{L:0.04,M:3000,S:0.12},39:{L:0.02,M:3180,S:0.12},40:{L:0.01,M:3340,S:0.12},41:{L:0.00,M:3480,S:0.12},
42:{L:-0.02,M:3630,S:0.12}
22:{L:-0.0868,M:481,S:0.13605},23:{L:0.2119,M:537,S:0.14635},24:{L:0.5281,M:606,S:0.16134},25:{L:0.8258,M:694,S:0.18077},
26:{L:1.0501,M:792,S:0.19889},27:{L:1.2084,M:899,S:0.21323},28:{L:1.2599,M:1017,S:0.22437},29:{L:1.2539,M:1152,S:0.22982},
30:{L:1.2262,M:1306,S:0.23082},31:{L:1.1223,M:1482,S:0.22733},32:{L:1.0122,M:1681,S:0.21846},33:{L:0.8746,M:1897,S:0.20681},
34:{L:0.7299,M:2126,S:0.19407},35:{L:0.5929,M:2362,S:0.18059},36:{L:0.4534,M:2602,S:0.17028},37:{L:0.3462,M:2835,S:0.16139},
38:{L:0.2636,M:3050,S:0.15513},39:{L:0.2069,M:3239,S:0.15004},40:{L:0.1670,M:3415,S:0.14649},41:{L:0.1517,M:3596,S:0.14359},
42:{L:0.1308,M:3787,S:0.14127}
}
};