Table 4. A comparison of study findings to existing literature for a local set of MEWS.

Study findings	Proportion of deviation from published MEWS in template inTable 1 (% agreement by consensus)	Previous literature
Respiratory rate	4/7 cut points deviated from published MEWS [15] (100.0% agreement by ranking within the high tertile region of 7 to 9 by applying a strict rule)	Measured in all the studies on reliability and validity testing and in nine studies on performance of MEWS [1].
		Measured in all six papers included in a systematic review [41].
		Found to be the best discriminator of clinical outcomes [59].
Heart rate	4/7 cut points deviated from published MEWS [15] (100.0% agreement by ranking within the high tertile region of 7 to 9 by applying a strict rule)	Measured in all the studies on reliability and validity and in eight studies on performance of MEWS [1]
		Measured in all six papers included in a systematic review [41].
Systolic blood pressure	4/7 cut points deviated from published MEWS [15] (100.0% agreement by ranking within the high tertile region of 7 to 9 by applying a strict rule)	A systolic blood pressure of 80–100 mmHg is reportedly an early sign frequently associated with SAEs [33].
		Measured in five studies for reliability and validity and in eight studies on performance of MEWS [1]
		Measured in all six papers included in a systematic review.
Temperature	All seven cut points deviated from published MEWS [15] (100.0% agreement by ranking within the high tertile region of 7 to 9 by applying a strict rule)	The top two most effective aggregate weighted track and trigger systems able to discriminate between survivors and non-survivors incorporated temperature monitoring [21].
		Measured in five studies on reliability and validity and in seven studies on performance of MEWS [1]
		Measured in 4/6 papers included in a systematic review [41].
Urine output	4/5 cut points deviated from published MEWS unchanged [25](100.0% agreement by ranking within the high tertile region of7 to 9 by applying a strict rule)	Measured in all six papers included in a systematic review [41] but found to be missing in 97.1% of sets of observations in one of the five studies [18].
		Measured in four studies on performance of MEWS [1] and in two studies on reliability and validity testing [14], [18]
Level of consciousness	The AVPU remained unchanged from the published literature[15] (62.5% agreement by applying a relaxed rule of rankingwithin the high tertile region of 7 to 9)	Alteration in mentation is reportedly an early sign frequently associated with SAEs [33].
		Measured in five studies on reliability and validity and in eight studies on performance of MEWS listed in Kyriacos et al., 2011.
		Measured in all six papers included in a systematic review [41].
Oxygen saturation	2/4 cut points deviated from published MEWS (Subbe, Kruger,Rutherford & Gemmel, 2001) (50.0% agreement by applyinga relaxed rule of ranking within the high tertile region of7 to 9)	Oxygen saturation of 90–95% is reportedly an early sign frequently associated with SAEs [33].
		Measured in two studies on reliability and validity [16], [17].
		Measured in 2/6 papers included in a systematic review [41].
		Measured in three studies on performance of MEWS [12], [21], [60] listed in Kyriacos et al., 2011.
Clinical variables onthe chart were not tobe scored	Inspired oxygen a new addition	Adapted with permission [61]
	Perfusion a new addition	Adapted from an existing chart at the research site
	Skin pallor/cyanosis	Adapted from an existing chart at the research site
	Pain score a new addition	Adapted with permission [28]
	Pain medication	Adapted from an existing chart at the research site
	Sweating a new addition
	Wound oozing	Adapted from an existing chart at the research site
	Pedal pulses	Adapted from an existing chart at the research site
	Blood glucose	Consensus group
	Finger prick Hb	Adapted from an existing chart at the research site
	IV therapy	Adapted from an existing chart at the research site
	‘Looks unwell’ a new addition	Adapted with permission [61]