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The combination of clinical predictors and prognostic biomarkers has been suggested as a promising approach to optimize the prognostic certainty and thus the management of LRTI patients [ 49].
Where parents believed in the prognostic certainty of the MRD test, we have seen that, in the sampled consultations, doctors had presented the MRD test with certainty.
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In a decisional sphere burdened by such limited prognostic certainties, an individual approach is infinitely more acceptable than a statistical approach: any decision ought to be based upon the individual circumstances of each newborn rather than on reference to guidelines, especially if these are based on gestational age.
In the sampled consultations for these two families, both doctors had expressed certainty about the prognostic value of the MRD test.
However, some parents believed that the MRD test was equivalent to the standard bone marrow test in terms of the certainty about its prognostic meaning and its implications for intensity of treatment.
However, it is necessary to replicate and establish this association in other populations of the region before its prognostic value can be suggested with certainty.
Till further evidence is generated to establish the prognostic implications of fungal colonization with certainty, these patients should be closely monitored, in order to enable earlier detection of invasive or disseminated fungal infection.
What emerges from our data is that the favourable prognostic effect of Sox11 cannot be with certainty attributed to its absence from GSCs, as originally suggested (Hide et al, 2009), as cases coexpressing Sox11 and nestin are not significantly different from those with Sox11-positivity in terms of survival.
This is because prognostic estimates always represent probabilities and not absolute certainties on the actual outcome at any given time.
The possible role of cognitive impairment as a prognostic factor was not used considering the lack of certainty on its role [ 12].
Narrower confidence intervals, whether around point estimates of treatment effect modification, prognostic risk or diagnostic accuracy, are measures of increased certainty.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com