Table 6.
Evidence table: Development and validation studies – Undifferentiated patient groups
| Authors (year), country | Participants | Tool (cut-off if provided) | Results |
|---|---|---|---|
| Burch et al. (2008) [63], South Africa Risk of bias: High |
790 | MEWS | Hospital admission MEWS 0–2 (ref) MEWS 3–4: RR 1.3 (95% CI 1.1 to 1.6) MEWS ≥5: RR 1.7 (95% CI 1.5 to 2.0) In-hospital mortality MEWS 0–2 (ref) MEWS 3–4: RR 2.8 (95% CI 1.7 to 4.8) MEWS ≥5: RR 4.6 (95% CI 2.7 to 7.8) |
| Correia et al. (2014) [55], Portugal Risk of bias: Unclear |
65 | EWS | Length of hospital stay & Mortality Score at 24 h and 12 h seemed to predict both length of stay and mortality (p < 0.05). The EWS would have increased early medical attention by 40% if a threshold of ≥3 was used. |
| Dundar et al. (2015) [41], Turkey Risk of bias: Low |
671 | MEWS VIEWS |
Hospitalisation MEWS (≥3): AUROC 0.73 (95% CI 0.69–0.77) VIEWS (≥6): AUROC 0.76 (95% CI 0.72–0.79) In-hospital mortality MEWS (≥4): AUROC 0.89 (95% CI 0.84–0.94) VIEWS (≥8): AUROC 0.90 (95% CI 0.86–0.94) |
| Eick et al. (2015) [42], Germany Risk of bias: Low |
5730 | MEWS | In-hospital mortality AUROC: 0.71 (0.67–0.75; p < 0.001) |
| Graham et al. (2007) [56], Hong Kong Risk of bias: Unclear (Conference abstract) |
413 | MEWS (>4) | In-hospital mortality OR 8.3 (95% CI 1.1–60.4), p = 0.013 ED re-attendance within 48 h OR 45.2 (95% CI 3.4–568.9), p < 0.0001 |
| Heitz et al. (2010) [43], USA Risk of bias: Low |
280 | MEWS Max (≥4) MEWS plus |
Need for higher level of care or mortality within 24 h MEWS Max: AUROC 0.73 (95% CI, 0.66–0.79) MEWS Plus: AUROC 0.76 (95% CI, 0.69–0.82) |
| Junhasavasdiku et al. (2012) [58], Thailand Risk of bias: Unclear |
381 | MEWS | Mortality MEWS at ED was associated with mortality (p < 0.001) |
| Naidoo et al. (2014) [62], South Africa Risk of bias: High |
265 | TEWS | Discharge within 24 h of admission, admission to a ward, admission to an intensive care unit (ICU), and death in hospital. TEWS <7: 53.7% discharged; no admitted to ICU; none died. TEWS ≥7: 18.7% discharged; 3 admitted to ICU; 4 died |
| Olsson et al. (2003) [33], Sweden Risk of bias: Low |
1027 | APACHE II RAPS REMS |
Mortality REMS: AUROC: 0.91 ± 0.02 RAPS: AUROC: 0.87 ± 0.02 APACHE II: AUROC: 0.90 ± 0.02 |
| Olsson et al. (2004) [34], Sweden Risk of bias: Low |
11,751 | RAPS REMS |
Mortality RAPS: AUROC: 0.65 ± 0.02 REMS: AUROC: 0.85 ± 0.01 |
| Subbe et al. (2006) [50], UK Risk of bias: Low |
(a) 53 unselected; (b): 49 ICU admission; (c): 49 ED admission, transferred to ward then ICU | MEWS (>2) ASSIST (>3) MET (=1) MTS (orange or red) |
Patients identified as critically ill (at risk of deterioration) MTS: Sensitivity: (a) 15%; (b) 96%; (c) 65% MEWS: Sensitivity (a): 8%; (b) 77%; (c) 55% ASSIST: Sensitivity (a): 0%; (b) 22%; (c) 16% MET: Sensitivity (a) 0%; (b) 2%; (c) 7% |
| Wang et al. (2016) [60], Taiwan Risk of bias: Unclear |
99 | CCI MEWS |
Survival to discharge CCI: Adjusted OR 0.57 (95% CI 0.38–0.84); p = 0.005 Peri-arrest MEWS: Adjusted OR 0.77 (95% CI 0.60–0.97); p = 0.028 |