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Abstract：
Predicting the short- and long-term outcomes of extremely preterm infants remains a challenge. Multivariable prognostic models might be valuable tools for clinicians, parents, and policymakers for providing accurate outcome estimates. In this perspective, we discuss the opportunities and challenges of using prognostic models in extremely preterm infants at population and individual levels. At a population level, these models could support the development of guidelines for decisions about treatment limits and may support policy processes such as benchmarking and resource allocation. At an individual level, these models may enhance prenatal counselling conversations by considering multiple variables and improving transparency about expected outcomes. Furthermore, they may improve consistency in projections shared with parents. For the development of prognostic models, we discuss important considerations such as predictor and outcome measure selection, clinical impact assessment, and generalizability. Lastly, future recommendations for developing and using prognostic models are suggested. Importantly, the purpose of a prognostic model should be clearly defined, and integrating these models into prenatal counselling requires thoughtful consideration.
摘要：
预测极端早产儿的短期和长期结果仍然是一个挑战。多变量预后模型可能是临床医生有价值的工具，父母,和决策者提供准确的结果估计。从这个角度来看,我们从人群和个体层面讨论了在极早产儿中使用预后模型的机遇和挑战.在人口层面,这些模型可以支持制定有关治疗限制的决策指南，并可能支持诸如基准和资源分配之类的政策过程。在个人层面,这些模型可以通过考虑多个变量并提高预期结局的透明度来增强产前咨询对话.此外，它们可以提高与父母分享的预测的一致性。为了发展预后模型，我们讨论了重要的考虑因素，如预测因子和结果度量选择，临床影响评估，和普适性。最后,提出了开发和使用预后模型的未来建议.重要的是,预后模型的目的应该明确定义，将这些模式纳入产前咨询需要深思熟虑。
