Evidence map›Paper›PMID 30791952›Full record

ArticleCritical care (London, England)2019

Prognostic accuracy of the Hamilton Early Warning Score (HEWS) and the National Early Warning Score 2 (NEWS2) among hospitalized patients assessed by a rapid response team.

Shannon M Fernando, Alison E Fox-Robichaud, Bram Rochwerg, Pierre Cardinal, Andrew J E Seely, Jeffrey J Perry, Daniel I McIsaac, Alexandre Tran, Steven Skitch, Benjamin Tam and 4 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Critical care (London, England), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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  5. Computational and structural biotechnology journal · 2024
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Shannon M FernandoDivision of Critical Care, Department of Medicine, University of Ottawa, Ottawa, ON, Canada. sfern014@uottawa.ca.ORCID 0000-0003-4549-4289
Alison E Fox-RobichaudDivision of Critical Care, Department of Medicine, McMaster University, Hamilton, ON, Canada.
Bram RochwergDivision of Critical Care, Department of Medicine, McMaster University, Hamilton, ON, Canada.
Pierre CardinalDivision of Critical Care, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.
Andrew J E SeelyDivision of Critical Care, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.
Jeffrey J PerryDepartment of Emergency Medicine, University of Ottawa, Ottawa, ON, K1Y 4E9, Canada.
Daniel I McIsaacSchool of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
Alexandre TranSchool of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
Steven SkitchDivision of Critical Care, Department of Medicine, McMaster University, Hamilton, ON, Canada.
Benjamin TamDivision of Critical Care, Department of Medicine, McMaster University, Hamilton, ON, Canada.
Michael HickeyDivision of Critical Care, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.
Peter M ReardonDivision of Critical Care, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.
Peter TanuseputroSchool of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
Kwadwo KyeremantengDivision of Critical Care, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRapid response teams (RRTs) respond to hospitalized patients experiencing clinical deterioration and help determine subsequent management and disposition. We sought to evaluate and compare the prognostic accuracy of the Hamilton Early Warning Score (HEWS) and the National Early Warning Score 2 (NEWS2) for prediction of in-hospital mortality following RRT activation. We secondarily evaluated a subgroup of patients with suspected infection.

methodsWe retrospectively analyzed prospectively collected data (2012-2016) of consecutive RRT patients from two hospitals. The primary outcome was in-hospital mortality. We calculated the number needed to examine (NNE), which indicates the number of patients that need to be evaluated in order to detect one future death.

resultsFive thousand four hundred ninety-one patients were included, of whom 1837 (33.5%) died in-hospital. Mean age was 67.4 years, and 51.6% were male. A HEWS above the low-risk threshold (≥ 5) had a sensitivity of 75.9% (95% confidence interval (CI) 73.9-77.9) and specificity of 67.6% (95% CI 66.1-69.1) for mortality, with a NNE of 1.84. A NEWS2 above the low-risk threshold (≥ 5) had a sensitivity of 84.5% (95% CI 82.8-86.2), and specificity of 49.0% (95% CI: 47.4-50.7), with a NNE of 2.20. The area under the receiver operating characteristic curve (AUROC) was 0.76 (95% CI 0.75-0.77) for HEWS and 0.72 (95% CI: 0.71-0.74) for NEWS2. Among suspected infection patients (n = 1708), AUROC for HEWS was 0.79 (95% CI 0.76-0.81) and for NEWS2, 0.75 (95% CI 0.73-0.78).

conclusionsThe HEWS has comparable clinical accuracy to NEWS2 for prediction of in-hospital mortality among RRT patients.

Indexed as

AgedAged, 80 and overArea Under CurveEmergency RespondersFemaleHospitalizationHospital MortalityHumansIntensive Care UnitsLogistic ModelsMaleMiddle AgedOntarioPrognosisProportional Hazards ModelsProspective StudiesEarly warning systemsIntensive care unitRapid response teamsSepsis

Identifiers

PMID30791952
PMCPMC6385382

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

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.