Table 2.
Design characteristics of 84 studies describing external validation of early warning score
| Reference | Type of dataset | Country | Year | EWS validated | Mean age | Male (%) |
|---|---|---|---|---|---|---|
| Abbott 201663 | Prospective cohort | UK | 2013 | NEWS | 63 | 48 |
| Abbott 201564 | Prospective cohort | UK | 2013 | NEWS | 61 | 46 |
| Alvarez 201332 | Prospective cohort | US | 2009-10 | MEWS | 51 | 54 |
| Atmaca 201865 | Prospective cohort | Turkey | 2014 | NEWS | 57 | 55 |
| Badriyah 201433 | Retrospective cohort/database | UK | 2006-08 | NEWS | 68 | 47 |
| Bartkowiak 201966 | Retrospective cohort/database | US | 2008-16 | eCART, NEWS, MEWS | 54 | 43 |
| Beane 201867 | Retrospective cohort/database | Sri Lanka | 2015 | MEWS, NEWS, CART, ViEWS | 43 | 41 |
| Bleyer 201134 | Retrospective cohort/database | US | 2008-09 | NEWS, ViEWS | 57 | 51 |
| Brabrand 201768 | Retrospective cohort/database | Denmark | 2012 | NEWS, Worthing, Groarke, Goodacre | 67 | 50 |
| Brabrand 201869 | Retrospective cohort/database | Denmark | Missing | NEWS | 74 | 49 |
| Cei 200970 | Prospective cohort | Italy | 2005-06 | MEWS | 79 | 44 |
| Churpek 201771 | Retrospective cohort/database | US | 2008-16 | eCART, NEWS, MEWS | 57 | 46 |
| Churpek 201772 | Retrospective cohort/database | US | 2008-16 | NEWS, MEWS | 57 | 48 |
| Churpek 201373 | Retrospective cohort/database | US | 2008-11 | CEWS, MEWS, ViEWS, CART | 55 | 44 |
| Churpek 201436 | Retrospective cohort/database | US | 2008-13 | MEWS | 60 | 40 |
| Churpek 201274 | Other | US | 2008-11 | MEWS | 59 | 52 |
| Churpek 20128 | Retrospective cohort/database | US | 2008-11 | CART, MEWS | 54 | 43 |
| Churpek 201435 | Retrospective cohort/database | US | 2008-11 | ViEWS | 54 | 43 |
| Cooksley 201275 | Retrospective cohort/database | UK | 2009-11 | NEWS, MEWS | 63 | 51 |
| Cuthbertson 201038 | Prospective cohort | UK | 2005 | EWS, MEWS | 65 | 51 |
| De Meester 201376 | Prospective cohort | Belgium | 2009-10 | MEWS | 59 | 60 |
| DeVoe 201677 | Retrospective cohort/database | US | 2007-13 | MEWS | 75 | 61 |
| Douw 201778 | Retrospective cohort/database | Netherlands | 2013-14 | DENWIS | 60 | 47 |
| Duckitt 200739 | Prospective cohort | UK | 2003-05 | EWS | 73 | 52 |
| Dziadzko 201840 | Retrospective cohort/database | US | 2017 | APPROVE, MEWS, NEWS | 56 | 33 |
| Eccles 201479 | Retrospective cohort/database | UK | 2012 | NEWS | 70 | 50 |
| Escobar 201241 | Retrospective cohort/database | US | 2006-09 | MEWS | 65 | 45 |
| Fairclough 200980 | Prospective cohort | UK | 2004-06 | MEWS | 73 | 43 |
| Faisal 201842 | Retrospective cohort/database | UK | 2014-15 | CARM | 68 | 48 |
| Finlay 201481 | Retrospective cohort/database | US | 2009-10 | MEWS | 65 | NR |
| Forster 201882 | Retrospective cohort/database | UK | 2015-17 | NEWS | 63 | 47 |
| Garcea 200683 | Retrospective cohort/database | UK | 2002-06 | EWS | 57 | NR |
| Gardner 200684 | Prospective cohort | UK | 2003 | MEWS | 59 | 50 |
| Ghanem 201185 | Prospective cohort | Israel | 2008-09 | MEWS | 75 | 52 |
| Ghosh 201843 | Retrospective cohort/database | US | 2012-13 | MEWS, NEWS | 59 | NR |
| Green 201886 | Retrospective cohort/database | US | 2008-13 | MEWS, NEWS, eCART | 62 | 41 |
| Harrison 200645 | Retrospective cohort/database | Australia | 2000 | MEWS | NR | NR |
| Hodgson 201787 | Retrospective cohort/database | UK | 2012-14 | NEWS | 74 | NR |
| Hydes 201888 | Retrospective cohort/database | UK | 2010-14 | NEWS, EWS, MEWS, MEWS+age, Worthing | 57 | 61 |
| Jo 201689 | Retrospective cohort/database | South Korea | 2013-14 | NEWS | 70 | 63 |
| Kellett 201290 | Retrospective cohort/database | Canada | 2005-11 | ViEWS | 63 | 49 |
| Kellett 201691 | Prospective cohort | Canada | 2005-16 | ViEWS | 65 | 49 |
| Kim 201892 | Retrospective cohort/database | South Korea | 2014-15 | NEWS | 65 | 70 |
| Kim 201793 | Retrospective cohort/database | South Korea | 2008-15 | MEWS | 61 | 65 |
| Kipnis 201649 | Retrospective cohort/database | US | 2010-13 | eCART, NEWS | 65 | 46 |
| Kovacs 201694 | Retrospective cohort/database | UK | 2011-13 | NEWS | 57 | 47 |
| Kruisselbrink 201695 | Prospective cohort | Uganda | 2013 | MEWS | 43 | 54 |
| Kwon 201851 | Retrospective cohort/database | South Korea | 2017 | MEWS | 58 | 50 |
| LeLagadec 202096 | Retrospective case-control | Australia | 2014-17 | NEWS | 73 | 53 |
| Lee 201897 | Retrospective cohort/database | South Korea | 2013-14 | NEWS | 62 | 58 |
| Liljehult 201698 | Retrospective cohort/database | Denmark | 2012 | NEWS | 72 | 50 |
| Luis 201853 | Retrospective cohort/database | Portugal | 2012 | NEWS | NR | 48 |
| Moore 201754 | Retrospective cohort/database | Gabon, Malawi, Sierra Leone, Tanzania, Uganda, and Zambia | 2009-15 | MEWS | 36 | 49 |
| Mulligan 201099 | Prospective cohort | UK | 2007 | EWS | 48 | 85 |
| Öhman 2018100 | Retrospective cohort/database | Denmark | 2008-10 | MARS | 65 | 50 |
| Opio 2013101 | Retrospective cohort/database | Uganda | 2012 | ViEWS | 45 | 42 |
| Opio 2013102 | Prospective cohort | Ireland | 2011-13 | TOTAL | 64 | 53 |
| Pedersen 2018103 | Retrospective cohort/database | Denmark | 2014 | NEWS | 74 | 42 |
| Perera 201156 | Prospective cohort | Sri Lanka | 2009 | MEWS | 49 | 48 |
| Pimentel 2019104 | Retrospective cohort/database | UK | 2012-16 | NEWS | 68 | 48 |
| Plate 2018105 | Retrospective cohort/database | Netherlands | 2014-16 | ViEWS | 61 | 65 |
| Prytherch 201057 | Retrospective cohort/database | UK | 2006-08 | EWS, Goldhill, MEWS, MEWS+age, Worthing | 68 | 48 |
| Redfern 2018106 | Retrospective cohort/database | UK | 2010-16 | NEWS | 63 | 47 |
| Redfern 201858 | Retrospective cohort/database | UK | 2016 | LDTEWS:NEWS, NEWS | 73 | 50 |
| Roberts 2017107 | Retrospective cohort/database | Sweden | 2014-15 | NEWS | NR | 60 |
| Romero 2017108 | Retrospective cohort/database | US | 2011 | GMEWS, Kirkland, MEWS, NEWS, ViEWS, Worthing | 59 | 49 |
| Romero 2014109 | Retrospective cohort/database | US | 2011 | MEWS, GMEWS, Worthing, ViEWS, NEWS | 59 | 49 |
| Rylance 2009110 | Prospective cohort | Tanzania | 2005 | MEWS | NR | 34 |
| Silke 201059 | Retrospective cohort/database | Ireland | 2000-04 | MARS | 59 | 48 |
| Smith 2008111 | Retrospective cohort/database | UK | 2006 | EWS, Goldhill, MEWS, MEWS+age, Worthing | 68 | 48 |
| Smith 2013112 | Retrospective cohort/database | UK | 2006-08 | NEWS, EWS, Goldhill, MEWS, MEWS+age, Worthing | 68 | 47 |
| Smith 2016113 | Retrospective cohort/database | UK | 2011-13 | NEWS | 62 | 48 |
| Smith 2016114 | Retrospective cohort/database | US | 2014-15 | NEWS | 53 | NR |
| Spagnolli 2017115 | Prospective cohort | Italy | 2013-15 | NEWS | 72 | 50 |
| Stark 2015116 | Retrospective cohort/database | US | 2013-14 | MEWS | 62 | 65 |
| Stræede 2014117 | Retrospective cohort/database | Denmark | 2008-09 | SCS, HOTEL | 62 | 52 |
| Subbe 2001118 | Retrospective cohort/database | UK | 2000 | MEWS, MEWS+age | 63 | 45 |
| Suppiah 2014119 | Prospective cohort | UK | 2010 | MEWS | 56 | 50 |
| Tirkkonen 2014120 | Prospective cohort | Finland | 2010 | NEWS | 65 | 53 |
| Tirotta2017121 | Prospective cohort | Italy | 2012 | MEWS, TOTAL | 73 | 50 |
| Vaughn 2018122 | Retrospective cohort/database | US | 2011-15 | MEWS | 54 | NR |
| VonLilienfeld-Toal 2007123 | Retrospective cohort/database | Missing | 2002-04 | MEWS | 40 | 51 |
| Watkinson 201861 | Retrospective cohort/database | UK | 2015-17 | CART, CEWS, Goldhill, MEWS, MEWS+age, NEWS | 68 | 49 |
| Wheeler 201362 | Prospective cohort | Malawi | 2012 | MEWS, HOTEL | 40 | 51 |
APPROVE=accurate prediction of prolonged ventilation; CARM=computer aided risk of mortality; CART=cardiac arrest risk triage; CEWS=centile early warning score; DENWIS=Dutch early nurse worry indicator score; eCART=electronic cardiac arrest risk triage; EWS=early warning score; GMEWS=global modified early warning score; HOTEL=hypotension, oxygen saturation, temperature, ECG [electrocardiogram] abnormality, loss of independence; LDTEWS=laboratory decision tree early warning score; MARS=medical admissions risk system; MEWS=modified early warning score; NEWS=national early warning score; NR=not reported; SCS=Simple clinical score; TOTAL=tachypnoea, oxygen saturation, temperature, alert and loss of independence; ViEWS=VitalPAC early warning score.