An external validation of a novel predictive algorithm for male nipple areolar positioning: an improvement to current practice through a multicenter endeavor Article Swipe

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Floyd W. Timmermans , Laure Ruyssinck , Sterre E. Mokken , Marlon E. Buncamper , Kevin M. Veen , Margriet G. Mullender , Karel Claes , Mark‐Bram Bouman , S. Monstrey , Timotheus C. van de Grift ·

YOU? · · 2021 · Open Access · · DOI: https://doi.org/10.1080/2000656x.2021.1994982

The correct positioning of nipple-areolar complexes (NAC) during gender-affirming mastectomies remains a particular challenge. Recently, a Dutch two-step algorithm was proposed predicting the most ideal NAC-position derived from a large cisgender male cohort. We aimed to externally validate this algorithm in a Belgian cohort. The Belgian validation cohort consisted of cisgender men. Based on patient-specific anthropometry, the algorithm predicts nipple-nipple distance (NN) and sternal-notch-to-nipple distance (SNN). Predictions were externally validated using the performance measures: R²-value, means squared error (MSE) and mean absolute percentage error (MAPE). Additionally, data were collected from a Belgian and Dutch cohort of transgender men having undergone mastectomy with free nipple grafts. The observed and predicted NN and SNN were compared and the inter-center variability was assessed. A total of 51 Belgian cisgender and 25 transgender men were included, as well as 150 Dutch cisgender and 96 transgender men. Respectively, the performance measures (R²-value, MSE and MAPE) for NN were 0.315, 2.35 (95%CI:0-6.9), 4.9% (95%CI:3.8-6.1) and 0.423, 1.51 (95%CI:0-4.02), 4.73%(95%CI:3.7-5.7) for SNN. When applying the algorithm to both transgender cohorts, the predicted SNN was larger in both Dutch (17.1_measured(±1.7) vs. 18.7_predicted(±1.4), p= <0.001) and Belgian (16.2_measured(±1.8) vs. 18.4_predicted(±1.5), p= <0.001) cohorts, whereas NN was too long in the Belgian (22.0_measured(±2.6) vs. 21.2_predicted(±1.6), p = 0.025) and too short in the Dutch cohort (19.8_measured(±1.8) vs. 20.7_predicted(±1.9), p = 0.001). Both models performed well in external validation. This indicates that this two-step algorithm provides a reproducible and accurate clinical tool in determining the most ideal patient-tailored NAC-position in transgender men seeking gender-affirming chest surgery.

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Medicine Cohort Anthropometry Transgender Demography Statistics Algorithm Mathematics Internal medicine Psychology Sociology Psychoanalysis

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Type: article
Language: en
Landing Page: https://doi.org/10.1080/2000656x.2021.1994982
PDF: https://www.tandfonline.com/doi/pdf/10.1080/2000656X.2021.1994982?needAccess=true
OA Status: diamond
Cited By: 2
References: 22
Related Works: 10
OpenAlex ID: https://openalex.org/W3212762835

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DOI: https://doi.org/10.1080/2000656x.2021.1994982

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Title: An external validation of a novel predictive algorithm for male nipple areolar positioning: an improvement to current practice through a multicenter endeavor

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Language: en

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Publication year: 2021

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Publication date: 2021-11-07

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Authors: Floyd W. Timmermans, Laure Ruyssinck, Sterre E. Mokken, Marlon E. Buncamper, Kevin M. Veen, Margriet G. Mullender, Karel Claes, Mark‐Bram Bouman, S. Monstrey, Timotheus C. van de Grift

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Landing page: https://doi.org/10.1080/2000656x.2021.1994982

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Concepts: Medicine, Cohort, Anthropometry, Transgender, Demography, Statistics, Algorithm, Mathematics, Internal medicine, Psychology, Sociology, Psychoanalysis

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Cited by: 2

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