ArticleEmergency medicine journal : EMJ2019
Distributions of the National Early Warning Score (NEWS) across a healthcare system following a large-scale roll-out.
Article in Emergency medicine journal : EMJ, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 3 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
28 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- A comparison of qSOFA, SIRS and NEWS in predicting the accuracy of mortality in patients with suspected sepsis: A meta-analysis.PloS one · 2022Pooled it
- The Prognostic Accuracy of National Early Warning Score 2 on Predicting Clinical Deterioration for Patients With COVID-19: A Systematic Review and Meta-Analysis.Frontiers in medicine · 2021Pooled it
- National Early Warning Score Does Not Accurately Predict Mortality for Patients With Infection Outside the Intensive Care Unit: A Systematic Review and Meta-Analysis.Frontiers in medicine · 2021Pooled it
- Peripheral venous oxygen saturation as an auxiliary indicator for improving the prediction of early in-hospital mortality in the emergency department.International journal of emergency medicine · 2026Article
- Implementing a sepsis prediction score in out-of-hours primary care: Feasibility and acceptability study.The European journal of general practice · 2025Article
- Use of a digital application to enhance communication and triage between care homes and national health service community services in the United Kingdom: a qualitative evaluation.BMC geriatrics · 2025Article
- Smart emergency care: a narrative review of predictive machine learning models.Annals of translational medicine · 2025Review
- Effectiveness of Antibiotic Regimens in Reducing White Blood Cell Count Within Three to Five Days in Febrile Leukocytosis Treated With Ambulatory Therapy.Journal of clinical medicine research · 2025Article
- Improving the Predictive Accuracy of the National Early Warning Score 2: Protocol for Algorithm Refinement.JMIR research protocols · 2025Article
- Article
- National Early Warning Score in Predicting Adverse Outcomes for Patients Admitted to Emergency Department; a Prognostic Accuracy Study.Archives of academic emergency medicine · 2024Article
- Follow-up of perfusion index and inferior vena cava collapsibility index in fluid therapy in prerenal acute renal failure.Heliyon · 2023Article
- Use of pager devices in New Zealand public hospitals as a critical communication tool: Barriers & way forward.Heliyon · 2023Review
- Early warning scores and trigger recommendations must be used with care in older home nursing care patients: Results from an observational study.Nursing open · 2023Observational
- The accuracy of the National Early Warning Score 2 in predicting early death in prehospital and emergency department settings: a systematic review and meta-analysis.Annals of translational medicine · 2023Article
- NEWS2 in out-of-hospital settings, the ambulance and the emergency department.Clinical medicine (London, England) · 2022Review
- New clinical prediction model for early recognition of sepsis in adult primary care patients: a prospective diagnostic cohort study of development and external validation.The British journal of general practice : the journal of the Royal College of General Practitioners · 2022Article
- Impact of the COVID-19 pandemic on emergency department attendances and acute medical admissions.BMC emergency medicine · 2021Article
- National Early Warning Scores and COVID-19 deaths in care homes: an ecological time-series study.BMJ open · 2021Article
- Early Warning Scores in Patients with Suspected COVID-19 Infection in Emergency Departments.Journal of personalized medicine · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEarly warning scores (EWS) were developed in acute hospital settings to improve recognition and response to patient deterioration. In 2012, the UK Royal College of Physicians developed the National Early Warning Score (NEWS) to standardise EWS across the NHS. Its use was also recommended outside acute hospital settings; however, there is limited information about NEWS in these settings. From March 2015, NEWS was implemented across the healthcare system in the West of England, with the aim that NEWS would be calculated for all patients prior to referral into acute care.
aimTo describe the distribution and use of NEWS in out-of-hospital settings for patients with acute illness or long-term conditions, following system wide implementation.
methodAnonymised data were obtained from 115 030 emergency department (ED) attendances, 1 137 734 ambulance electronic records, 31 063 community attendances and 15 160 general practitioner (GP) referrals into secondary care, in the West of England. Descriptive statistics are presented.
resultsMost attendance records had NEWS=0-2: 80% in ED, 67% of ambulance attendances and 72% in the community. In contrast, only 8%, 18% and 11% of attendances had NEWS ≥5 (the trigger for escalation of care in-hospital), respectively. Referrals by a GP had higher NEWS on average (46% NEWS=0-2 and 30% NEWS ≥5). By April 2016, the use of NEWS was reasonably stable in ED, ambulance and community populations, and still increasing for GP referrals.
conclusionsNEWS ≥5 occurred in less than 20% of ED, ambulance and community populations studied and 30% of GP referrals. This suggests that in most out-of-hospital settings studied, high scores are reasonably uncommon.
Indexed as
Identifiers
What 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.