Supplementary Material for: Clinical Prediction Models and Predictors for Death or Adverse Neurodevelopmental Outcome in Term Newborns with Hypoxic-Ischemic Encephalopathy: A Systematic Review of the Literature

Background: Although many predictive parameters have been studied, an internationally accepted, validated predictive model to predict the clinical outcome of asphyxiated infants suffering from hypoxic-ischemic encephalopathy is currently lacking. The aim of this study was to identify, appraise and summarize available clinical prediction models, and provide an overview of all investigated predictors for the outcome death or neurodevelopmental impairment in this population. Methods: A systematic literature search was performed in Medline and Embase. Two reviewers independently included eligible studies and extracted data. The quality was assessed using PROBAST for prediction model studies and QUIPS assessment tools for predictor studies. Results: A total of nine prediction models were included. These models were very heterogeneous in number of predictors assessed, methods of model derivation, and primary outcomes. All studies had a high risk of bias following the PROBAST assessment and low applicability due to complex model presentation. A total of 104 predictor studies were included investigating various predictors, showing tremendous heterogeneity in investigated predictors, timing of predictors, primary outcomes, results, and methodological quality according to QUIPS. Selected high-quality studies with accurate discriminating performance provide clinicians and researchers an evidence map of predictors for prognostication after HIE in newborns. Conclusion: Given the low methodological quality of the currently published clinical prediction models, implementation into clinical practice is not yet possible. Therefore, there is an urgent need to develop a prediction model which complies with the PROBAST guideline. An overview of potential predictors to include in a prediction model is presented.

背景：尽管许多预测参数已得到研究，但目前尚缺乏一个国际上公认的、经过验证的预测模型，用于预测因窒息而患有缺氧缺血性脑病婴儿的临床结局。本研究旨在识别、评估和总结现有的临床预测模型，并概述该群体中所有研究过的死亡或神经发育障碍结局的预测因子。方法：在Medline和Embase数据库中进行了系统文献检索。两位审稿人独立地纳入了合格的研究并提取了数据。使用PROBAST评估工具对预测模型研究进行质量评估，使用QUIPS评估工具对预测因子研究进行评估。结果：共纳入了九个预测模型。这些模型在评估预测因子的数量、模型推导方法和主要结局方面存在高度异质性。所有研究在PROBAST评估后均存在高风险的偏倚，且由于模型呈现复杂，适用性较低。共纳入了104项预测因子研究，研究各种预测因子，根据QUIPS评估，在所研究的预测因子、预测时间、主要结局、结果和方法论质量方面表现出极大的异质性。选取的高质量研究，具有准确的区分性能，为临床医生和研究人员提供了新生儿HIE预后预测因子的证据地图。结论：鉴于目前发表的临床预测模型方法论质量较低，其临床应用尚不可行。因此，迫切需要开发一个符合PROBAST指南的预测模型。本文提出了预测模型中可能包含的潜在预测因子的概述。