SynthesisIntensive care medicine2007
Systematic review and evaluation of physiological track and trigger warning systems for identifying at-risk patients on the ward.
Synthesis in Intensive care medicine, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 110 papers, 10 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
110 citing papers in PubMed, 10 syntheses or guidelines pooled it.
- Effects of simulation in improving the self-confidence of student nurses in clinical practice: a systematic review.BMC medical education · 2023Pooled it
- Pooled it
- Quantitative systematic review: Sources of inaccuracy in manually measured adult respiratory rate data.Journal of advanced nursing · 2021Pooled it
- Early warning score validation methodologies and performance metrics: a systematic review.BMC medical informatics and decision making · 2020Pooled it
- Early warning scores for detecting deterioration in adult hospital patients: systematic review and critical appraisal of methodology.BMJ (Clinical research ed.) · 2020Pooled it
- Development and validation of early warning score system: A systematic literature review.Journal of biomedical informatics · 2020Pooled it
- Sources of inaccuracy in the measurement of adult patients' resting blood pressure in clinical settings: a systematic review.Journal of hypertension · 2017Pooled it
- Nurses' worry or concern and early recognition of deteriorating patients on general wards in acute care hospitals: a systematic review.Critical care (London, England) · 2015Pooled it
- Guideline
- Systematic review of paediatric alert criteria for identifying hospitalised children at risk of critical deterioration.Intensive care medicine · 2010Pooled it
- Comparative value of a simulation by gaming and a traditional teaching method to improve clinical reasoning skills necessary to detect patient deterioration: a randomized study in nursing students.BMC medical education · 2020Trial
- High-risk pregnancies and their association with severe maternal morbidity in Nepal: A prospective cohort study.PloS one · 2020Trial
- Prioritising Responses Of Nurses To deteriorating patient Observations (PRONTO) protocol: testing the effectiveness of a facilitation intervention in a pragmatic, cluster-randomised trial with an embedded process evaluation and cost analysis.Implementation science : IS · 2017Trial
- Trial
- Trial
- A randomized trial of real-time automated clinical deterioration alerts sent to a rapid response team.Journal of hospital medicine · 2014Trial
- Vital signs during complication-free recovery after major surgery: a retrospective analysis.Journal of clinical monitoring and computing · 2026Article
- Delta MEWS combined with SpOFrontiers in medicine · 2026Article
- When Nurses Worry: A Concept Analysis of Intuition in Clinical Deterioration.Journal of advanced nursing · 2025Review
- Nurse worry as a trigger for rapid response team activation improving outcomes: a retrospective cohort study in non-critical units.BMC nursing · 2025Article
50 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivePhysiological track and trigger warning systems (TTs) are used to identify patients outside critical care areas at risk of deterioration and to alert a senior clinician, Critical Care Outreach Service, or equivalent. The aims of this work were: to describe published TTs and the extent to which each has been developed according to established procedures; to review the published evidence and available data on the reliability, validity and utility of existing systems; and to identify the best TT for timely recognition of critically ill patients. DESIGN AND
settingSystematic review of studies identified from electronic, citation and hand searching, and expert informants. Cohort study of data from 31 acute hospitals in England and Wales. MEASUREMENTS AND
resultsThirty-six papers were identified describing 25 distinct TTs. Thirty-one papers described the use of a TT, and five were studies examining the development or testing of TTs. None of the studies met all methodological quality standards. For the cohort study, outcome was measured by a composite of death, admission to critical care, 'do not attempt resuscitation' or cardiopulmonary resuscitation. Fifteen datasets met pre-defined quality criteria. Sensitivities and positive predictive values were low, with median (quartiles) of 43.3 (25.4-69.2) and 36.7 (29.3-43.8), respectively.
conclusionA wide variety of TTs were in use, with little evidence of reliability, validity and utility. Sensitivity was poor, which might be due in part to the nature of the physiology monitored or to the choice of trigger threshold. Available data were insufficient to identify the best TT.
Indexed as
Identifiers
17318499What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.