SynthesisBMC emergency medicine2017
The effectiveness of physiologically based early warning or track and trigger systems after triage in adult patients presenting to emergency departments: a systematic review.
Synthesis in BMC emergency medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
What it found
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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
16 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Pooled it
- Performance of universal early warning scores in different patient subgroups and clinical settings: a systematic review.BMJ open · 2021Pooled it
- Efficiency of Early Warning Scores in Adult Emergency Department and Inpatient Populations: Overview of Reviews.The western journal of emergency medicine · 2026Review
- Development of indicator system for early warning of clinical nursing critical values in general wards: a Delphi study.BMC nursing · 2025Article
- [Early warning scores: a rapid umbrella review].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Review
- CARDS, a Novel Prognostic Index for Risk Stratification and In-Hospital Monitoring.Journal of clinical medicine · 2024Article
- Development and validation of the early warning system scores ontology.Journal of biomedical semantics · 2023Article
- Developing a real-time detection tool and an early warning score using a continuous wearable multi-parameter monitor.Frontiers in physiology · 2023Article
- Artificial Intelligence for the Prediction of In-Hospital Clinical Deterioration: A Systematic Review.Critical care explorations · 2022Review
- Implementation of automated early warning decision support to detect acute decompensation in the emergency department improves hospital mortality.BMJ open quality · 2022Article
- Evaluation of NEWS2 response thresholds in a retrospective observational study from a UK acute hospital.BMJ open · 2022Observational
- Wavelet Transform Artificial Intelligence Algorithm-Based Data Mining Technology for Norovirus Monitoring and Early Warning.Journal of healthcare engineering · 2021Article
- Failure of vital sign normalization is more strongly associated than single measures with mortality and outcomes.The American journal of emergency medicine · 2020Article
- Addressing overcrowding in an emergency department: an approach for identifying and treating influential factors and a real-life application.Israel journal of health policy research · 2020Article
- Developing outcome, process and balancing measures for an emergency department longitudinal patient monitoring system using a modified Delphi.BMC emergency medicine · 2019Article
- Related factors of the nursing diagnosis ineffective breathing pattern in an intensive care unit.Revista latino-americana de enfermagem · 2019Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
Abstract
backgroundChanges to physiological parameters precede deterioration of ill patients. Early warning and track and trigger systems (TTS) use routine physiological measurements with pre-specified thresholds to identify deteriorating patients and trigger appropriate and timely escalation of care. Patients presenting to the emergency department (ED) are undiagnosed, undifferentiated and of varying acuity, yet the effectiveness and cost-effectiveness of using early warning systems and TTS in this setting is unclear. We aimed to systematically review the evidence on the use, development/validation, clinical effectiveness and cost-effectiveness of physiologically based early warning systems and TTS for the detection of deterioration in adult patients presenting to EDs.
methodsWe searched for any study design in scientific databases and grey literature resources up to March 2016. Two reviewers independently screened results and conducted quality assessment. One reviewer extracted data with independent verification of 50% by a second reviewer. Only information available in English was included. Due to the heterogeneity of reporting across studies, results were synthesised narratively and in evidence tables.
resultsWe identified 6397 citations of which 47 studies and 1 clinical trial registration were included. Although early warning systems are increasingly used in EDs, compliance varies. One non-randomised controlled trial found that using an early warning system in the ED may lead to a change in patient management but may not reduce adverse events; however, this is uncertain, considering the very low quality of evidence. Twenty-eight different early warning systems were developed/validated in 36 studies. There is relatively good evidence on the predictive ability of certain early warning systems on mortality and ICU/hospital admission. No health economic data were identified.
conclusionsEarly warning systems seem to predict adverse outcomes in adult patients of varying acuity presenting to the ED but there is a lack of high quality comparative studies to examine the effect of using early warning systems on patient outcomes. Such studies should include health economics assessments.
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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.