Davies Michael J, Wang Jim X, Norman Robert J
Reproductive Medicine Unit, Department of Obstetrics and Gynaecology, University of Adelaide, Adelaide, Australia.
Hum Reprod. 2004 May;19(5):1049-51. doi: 10.1093/humrep/deh202. Epub 2004 Mar 25.
It has been proposed that use of performance indicators for assisted reproduction treatment (ART) should be revised to better reflect the burden of treatment endured by a couple, and to place greater emphasis on the desired outcome of healthy babies. Recently, the BESST (birth emphasizing a successful singleton at term) score as a routine measurement for use in ART has been suggested. We applied the BESST index to a sample of ART patients and found that the BESST score was sensitive to the effects of patient age and extremes in the number of embryos transferred. However, the statistical properties of the index placed great weight on the effective implantation rate, which when applied to a time series in which implantation rates were improving, showed BESST scores to increase simultaneously with multiple pregnancy rates. This limits the completeness of the summary score as an expression of benefits compared to risks. A modified BESST index, not including cycles of initiated treatment as a denominator, indicated that the ART births contained a substantially lower proportion of BESST babies when compared to the entire population of births.
有人提议，辅助生殖治疗（ART）的性能指标应进行修订，以更好地反映夫妇所承受的治疗负担，并更加强调健康婴儿这一期望结果。最近，有人建议将BESST（足月单胎成功出生）评分作为ART中的常规测量指标。我们将BESST指数应用于ART患者样本，发现BESST评分对患者年龄和移植胚胎数量的极端情况较为敏感。然而，该指数的统计特性非常重视有效着床率，当将其应用于着床率不断提高的时间序列时，BESST评分与多胎妊娠率同时上升。与风险相比，这限制了该汇总评分作为益处表达的完整性。一个不将启动治疗周期作为分母的改良BESST指数表明，与整个出生人群相比，ART出生的婴儿中BESST婴儿的比例要低得多。
