The PREP-S model is best to be used together with the PREP-L model. With good agreement between the predicted and observed risk of complications in the PREP-S at 48 hours in the low- and intermediate-risk groups, women with a predicted probability of complications below 50% can avoid unnecessary transfer to tertiary units. Women categorised to be low risk by the PREP-L model could be followed-up in an outpatient setting, with high- and very high-risk women monitored as inpatients with regular intensive monitoring.
Provision of personalised risk information allows parents to have the opportunity to discuss the expected outcomes. It is important to recognise that all prediction models in this field, including the PREP models, provides risk estimates in the context of current care and clinical management decisions. The models are not designed to guide clinicians’ decisions on choice of management such as timing of delivery, administration of anti-hypertensives and magnesium sulfate. A woman with a low predicted risk should be viewed as an individual with low outcome risk if current care pathways are used, as it may be the clinical care that results in her low-risk status.
An important note is that the PREP models need proper evaluation of their impact in clinical practice. Thresholds for interventions (such as transfer to tertiary care units, or hospital admission) need to be established.
This model is provided for educational, training and information purposes. It must not be used to support medical decision making, or to provide medical or diagnostic services. Read our full disclaimer.
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