SynthesisBMJ open2021
Performance of universal early warning scores in different patient subgroups and clinical settings: a systematic review.
Synthesis in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 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
20 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Does the use of National Early Warning Scores (NEWS or NEWS2) in healthcare settings improve patient outcomes: a systematic review.Systematic reviews · 2026Pooled it
- Factors underpinning the performance of implemented artificial intelligence-based patient deterioration prediction systems: reasons for selection and implications for hospitals and researchers.Journal of the American Medical Informatics Association : JAMIA · 2025Pooled it
- Clinical Effectiveness of an Artificial Intelligence-Based Prediction Model for Cardiac Arrest in General Ward-Admitted Patients: A Non-Randomized Controlled Trial.Diagnostics (Basel, Switzerland) · 2026Article
- [Early warning scores: implementation, challenges and solutions within the initiative of quality in medicine].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Article
- Overcoming Barriers in the Introduction of Early Warning Scores for Prevention of In-Hospital Cardiac Arrests in Austrian Medical Centers.Healthcare (Basel, Switzerland) · 2025Article
- [Modified Delphi study about implementation of early warning scores].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Article
- Predicting In-Hospital Cardiac Arrest Using Machine Learning Models: Protocol for a Scoping Review.JMIR research protocols · 2025Article
- Article
- [Early warning scores: a rapid umbrella review].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Review
- The variable relationship between the National Early Warning Score on admission to hospital, the primary discharge diagnosis, and in-hospital mortality.Internal and emergency medicine · 2025Observational
- Microbiological and Clinical Features of Patients with Cellulitis in Tropical Australia: Disease Severity Assessment and Implications for Clinical Management.The American journal of tropical medicine and hygiene · 2025Article
- The effect of early warning scoring systems on adverse outcome in surgical patients: A systematic review.International journal of nursing studies advances · 2024Review
- Comparison of qSOFA, SIRS, NEWS and REWS Scores in Predicting Severity and 28-day Mortality of older Suspected Sepsis Cases; a Prognostic Accuracy Study.Archives of academic emergency medicine · 2024Article
- Development and validation of the early warning system scores ontology.Journal of biomedical semantics · 2023Article
- Performance of digital early warning score (NEWS2) in a cardiac specialist setting: retrospective cohort study.BMJ open · 2023Article
- Implementation of a digital early warning score (NEWS2) in a cardiac specialist and general hospital settings in the COVID-19 pandemic: a qualitative study.BMJ open quality · 2023Article
- Evaluating a novel, integrative dashboard for health professionals' performance in managing deteriorating patients:BMJ open quality · 2022Article
- Comparison of Nine Early Warning Scores for Identification of Short-Term Mortality in Acute Neurological Disease in Emergency Department.Journal of personalized medicine · 2022Article
- National Early Warning Score and New-Onset Atrial Fibrillation for Predicting In-Hospital Mortality or Transfer to the Intensive Care Unit in Emergency Department Patients with Suspected Bacterial Infections.Infection and drug resistance · 2022Article
- Comment on "The Brazilian Portuguese version of the psoriasis epidemiology screening tool (PEST-bp) is reliable and accurate: a cross-sectional study from southern Brazil".Anais brasileiros de dermatologiaArticle
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
Abstract
objectiveTo assess predictive performance of universal early warning scores (EWS) in disease subgroups and clinical settings.
designSystematic review. DATA SOURCES: Medline, CINAHL, Embase and Cochrane database of systematic reviews from 1997 to 2019. INCLUSION CRITERIA: Randomised trials and observational studies of internal or external validation of EWS to predict deterioration (mortality, intensive care unit (ICU) transfer and cardiac arrest) in disease subgroups or clinical settings.
resultsWe identified 770 studies, of which 103 were included. Study designs and methods were inconsistent, with significant risk of bias (high: n=16 and unclear: n=64 and low risk: n=28). There were only two randomised trials. There was a high degree of heterogeneity in all subgroups and in national early warning score (I
conclusionMethodology and quality of validation studies of EWS are insufficient to recommend their use in all diseases and all clinical settings despite good performance of EWS in some subgroups. There is urgent need for consistency in methods and study design, following consensus guidelines for predictive risk scores. Further research should consider specific diseases and settings, using electronic health record data, prior to large-scale implementation. PROSPERO REGISTRATION NUMBER: PROSPERO CRD42019143141.
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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.