Table 2a.

Test characteristics of the electronic sepsis alert (ESA) and ESA with clinician-identified cases. Severe sepsis was defined either as development of severe sepsis defined by consensus definitions requiring PICU care within 24 hours of ED stay or utilization of the ED sepsis pathway. Confounding by medical treatment analysis assumes that all patients treated on the sepsis pathway but not requiring PICU care were false positives (ie were unnecessarily treated). Additional sensitivity analysis included only those patients requiring vasoactive mediations as true positives.

	Sensitivity	Specificity	Positive Predictive Value	Negative Predictive Value	Likelihood Ratio Positive	Likelihood Ratio Negative
	Test Characteristic (95%CI)
ESA +	86.2 (82.0, 89.5)	99.1 (99.0, 99.2)	25.4 (22.8, 28.0)	100.0 (99.9, 100.0)	100.2 (92.59, 108.6)	0.14 (0.11, 0.18)
ESA + and Clinician Identified Sepsis	99.4 (97.8, 99.8)	99.1 (99.1, 99.2)	28.5 (25.9, 31.2)	100.0 (99.9, 100.0)	115.6 (107.9, 103.7)	0.01 (0.00, 0.02)
Confounding by Medical Intervention ESA + only	77.0 (70.5, 82.7)	99.0 (98.9, 99.1)	13.6 (11.7, 15.8)	100.0 (99.9, 100.0)	77.5(70.2, 85.6)	0.23 (0.2, 0.3)
Confounding by Medical Intervention ESA + and Clinician Identified Sepsis	99.0 (96.4, 99.9)	99.0 (98.9, 99.1)	16.9 (16.0, 17.8)	100.0 (99.9, 100.0)	99.6 (93.3, 106.2)	0.01 (0.00, 0.04)
True Positives Require Vasoactives: ESA+ only	83.9(66.3, 94.6)	98.9 (98.8, 99.0)	2.4(2.0, 2.8)	99.9(99.9, 100.0)	75.1(63.7, 88.6)	0.16 (0.07, 0.36)
True Positives Require Vasoactives: ESA+ and Clinician Identified Sepsis	95.1(83.5, 99.4)	98.9(98.8, 99.0)	3.5(3.2, 3.8)	100.0 (99.0, 100.0)	85.5 (78.0, 93.6)	0.05 (0.01, 0.19)