Table 5.
Evidence table: Development and validation studies – Patient groups differentiated by (suspected) condition
| Authors (year), country | Participants | Tool (cut-off if provided) | Results |
|---|---|---|---|
| Albright et al. (2014) [29], USA Risk of bias: Low |
850 pregnant & post partum women with suspected SIRS/sepsis | MEWS (≥5) REMS (≥6) |
ICU Admission within 48 h prediction MEWS: Sensitivity 100.0%, Specificity 77.6% REMS: Sensitivity 77.8%, Specificity 93.3% |
| Cildir et al. (2013) [38], Turkey Risk of bias: Low |
230 diagnosed with community acquired sepsis. | CCI (>5) MEWS (≤5) |
28-day mortality CCI: AUROC 0.65 (p = 0.001) MEWS: AUROC 0.61 (p = 0.008) 28-day mortality (n = 64 with sepsis) CCI: AUROC 0.65 (p = 0.18) MEWS:AUROC 0.57 (p = 0.48) 28-day mortality (n = 166 with severe sepsis) CCI: AUROC 0.62 (p = 0.006) MEWS: AUROC 0.60 (p = 0.04) |
| Considine et al. (2015) [39], Australia Risk of bias: Low |
600 adult with presenting with SOB, chest pain or abdominal pain | ED CIC | Episodes of unreported clinical deterioration T0 (Clinical decision making) (86.7%); T1 (Escalation of care protocol) (68.8%); T2 (Escalation of care protocol, single parameter TTS chart) (55.3%); T3 (Escalation of care protocol, single parameter TTS chart (year 2012)) (54.0%); (p = 0.14). |
| Corfield et al. (2014) [75] (and related conference abstract Corfield et al. (2012) [40], Scotland Risk of bias: Low |
2003 with sepsis (suspected or confirmed within 2 days of attendance and 2 or more of sepsis criteria) | NEWS (≥9 versus 0–4) | ICU (within 2 days) OR 5.76 (95% CI 3.22–10.31; p = 0.00) Mortality (30 days) OR 5.64 (95% CI 3.70–8.60; p = 0.00) Combined (ICU and/or mortality) 9–20: OR 5.78 (95% CI 4.02–8.31; p = 0.00) Cut-off point with highest Youden’s Index: NEWS 9 |
| Geier et al. (2013) [32] Germany Risk of bias: Low |
151 with suspected sepsis | ESI MEWS CCI Score |
In-hospital mortality ESI: Sensitivity 0.73, Specificity 0.0 MEWS: Sensitivity 0.43, Specificity 0.74 CCI: Sensitivity 0.82, Specificity 0.64 |
| Howell et al. (2007) [45], USA Risk of bias: Low |
2132 with suspected infection | mREMS | 28-day in-hospital survival AUROC 0.80 (95% CI 0.75–0.85) |
| Jo et al. (2013) [46], Korea Risk of bias: Low |
299 patients with blunt trauma, Injury severity score ≥ 9 | VIEWS-L | In-hospital mortality AUROC: 0.83 (95% CI 0.77–0.91) |
| Jo et al. (2016) [47], Korea Risk of bias: Low |
553 with pneumonia | NEWS-L score (≥3.1) NEWS (≥5) |
In-hospital mortality NEWS-L: AUROC 0.73 (0.66–0.80) NEWS: AUROC 0.70 (0.63–0.77) |
| Jones et al. (2005) [48], USA Risk of bias: Low |
91 with initial ED vital signs consistent with shock | SAPS II MPM0 II LODS |
In-hospital mortality SAPS II: AUROC 0.72 (95% CI 0.57–0.87) MPM0 II: AUROC 0.69 (95% CI 0.54–0.84) LODS: AUROC 0.60 (95% CI 0.45–0.76) |
| Nguyen et al. (2012) [59], USA Risk of bias: Unclear |
541 with severe sepsis | PIRO APACHE II |
In-hospital mortality PIRO: AUROC 0.71 (95% CI 0.66–0.75) APACHE II: AUROC 0.71 (95% CI 0.66–0.76) |
| Vorwerk et al. (2009) [51], UK Risk of bias: Low |
307 with sepsis | MEWS (≥5) Blood lactate (≥4 mmol/l) | 28-day mortality MEWS: AUROC 0.72 (95% CI 0.67 to 0.77) Lactate: AUROC 0.62 (0.54 to 0.70) |
| Williams et al. (2016) [52], Australia Risk of bias: Low |
8871 with presumed infection | SAPS II) SOFA APACHE II |
30-day mortality APACHE II: AUROC 0.90 (0.88–0.91) SAPS II: AUROC 0.90 (0.89–0.92) SOFA: AUROC 0.86 (0.84–0.88) |