Trial reportJAMA2025
Electronic Sepsis Screening Among Patients Admitted to Hospital Wards: A Stepped-Wedge Cluster Randomized Trial.
Trial report in JAMA, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 24 papers, 4 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.
Stepped-wedge Cluster Randomized Controlled Trial of Electronic Early Notification of Sepsis in Hospitalized Ward Patients (SCREEN)
Sepsis Optimal Recognition Toolkit in Children (SORT): An Early Recognition Tool for Children in Asia
Who cites it
24 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Clinical Surveillance Technologies in Nonintensive Care Unit Hospital Settings: Systematic Review and Bayesian Network Meta-Analysis of Randomized Trials.Journal of medical Internet research · 2026Pooled it
- Alerts and Alarms-Can Electronic Medical Records Help Children and Adolescents Survive Sepsis?Journal of paediatrics and child health · 2026Pooled it
- Impact of manual sepsis screening in hospitalized adult patients: A systematic review.Journal of hospital medicine · 2026Pooled it
- [S3 guideline on sepsis-prevention, diagnosis, therapy, and follow-up care-update 2025].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Guideline
- Clinical Decision Support for Septic Shock in the Emergency Department: A Cluster Randomized Trial.Pediatrics · 2025Trial
- Factors Associated With Mortality Among Septic Hospital Ward Patients.Mayo Clinic proceedings. Innovations, quality & outcomes · 2026Article
- From early recognition to precision medicine: advances in the diagnosis and management of adult sepsis and septic shock-a narrative review.Infection · 2026Review
- Recent advances in screening, diagnosis, prognosis and personalized treatment of sepsis.European journal of microbiology & immunology · 2026Review
- Sepsis Recognition and Management Gaps in Hospitals: A Post Hoc Analysis of a Subset of Data from the European Sepsis Care Survey.Infectious diseases and therapy · 2026Article
- Implementation of an AI-Based Clinical Decision Support System Predicting In-Hospital Cardiac Arrest in General Wards: A Multicenter Staggered-Implementation Study in Secondary Hospitals in Korea.Diagnostics (Basel, Switzerland) · 2026Article
- Surviving Sepsis Campaign: international guidelines for management of sepsis and septic shock 2026.Intensive care medicine · 2026Article
- Prioritizing the patient through a continuum of personalized care: insights from the 2026 Surviving Sepsis Campaign guidelines.Acute and critical care · 2026Article
- Challenges in early detection and prognostication of sepsis: new approaches from the emergency department and intensive care unit.EClinicalMedicine · 2026Review
- Clinical Profiles, Interventions, and Outcomes of Sepsis and Septic Shock in a Saudi Arabian Tertiary ICU: A Five-Year Retrospective Analysis.Healthcare (Basel, Switzerland) · 2026Article
- Artificial intelligence for sepsis management in the emergency department.BMC infectious diseases · 2026Review
- An artificial intelligence-powered learning health system to improve sepsis detection and quality of care: a before-and-after study.NPJ digital medicine · 2026Article
- Current standard of care for septic shock.Intensive care medicine · 2026Review
- Progress in sepsis prediction models: from traditional scoring systems to multimodal intelligence and clinical translation.Frontiers in medicine · 2026Review
- Digital Health Technologies and Standardized Protocols for Patient Safety in Hospital-Based Settings: A Scoping Review.Journal of multidisciplinary healthcare · 2026Review
- Deploying AI in the ICU: learning from successes and failures.Intensive care medicine · 2025Article
Corrections and comments
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Authors and funding
48 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Importance: Sepsis screening is recommended among hospitalized patients but is supported by limited evidence of effectiveness. Objective: To evaluate the effect of electronic sepsis screening, compared with no screening, on mortality among hospitalized ward patients. Design, Setting, and Participants: In a stepped-wedge, cluster randomized trial at 5 hospitals in Saudi Arabia, 45 wards (clusters) were randomized into 9 sequences, 5 wards each, to have sepsis screening implemented at 2-month periods. The study was conducted between October 1, 2019, and July 31, 2021, with follow-up through October 29, 2021. Intervention: An electronic alert, based on the quick Sequential Organ Failure Assessment score, was implemented in the electronic medical record in a silent mode that was activated to a revealed mode for sepsis screening. Main Outcomes and Measures: The primary outcome was 90-day in-hospital mortality. There were 11 secondary outcomes, including code blue activation, vasopressor therapy, incident kidney replacement therapy, multidrug-resistant organisms, and Clostridioides difficile. Results: Among 60 055 patients, 29 442 were in the screening group and 30 613 in the no screening group. They had a median age of 59 years (IQR, 39-68), and 30 596 were male (51.0%). Alerts occurred in 4299 of 29 442 patients (14.6%) in the screening group and 5394 of 30 613 (17.6%) in the no screening group. Within 12 hours of the alert, patients in the screening group were more likely to have serum lactate tested (adjusted relative risk [aRR], 1.30; 95% CI, 1.16-1.45) and intravenous fluid ordered (aRR, 2.17; 95% CI, 1.92-2.46) compared with those in the no screening group. In the primary outcome analysis, electronic screening resulted in lower 90-day in-hospital mortality (aRR, 0.85; 95% CI, 0.77-0.93; P < .001). Screening reduced vasopressor therapy and multidrug-resistant organisms but increased code blue activation, incident kidney replacement therapy, and C difficile. Conclusions and Relevance: Among hospitalized ward patients, electronic sepsis screening compared with no screening resulted in significantly lower in-hospital 90-day mortality. Trial Registration: ClinicalTrials.gov Identifier: NCT04078594.
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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.