Evidence map›Paper›PMID 40288808›Full record

ArticleBMJ health & care informatics2025

Digital innovation in healthcare: quantifying the impact of digital sepsis screening tools on patient outcomes-a multi-site natural experiment.

Kate Honeyford, Alf Timney, Runa Lazzarino, John Welch, Andrew Jonathan Brent, Anne Kinderlerer, Peter Ghazal, Anthony C Gordon, Shashank Patil, Graham Cooke and 2 more

Abstract readMulticenter Study
In one paragraph

Article in BMJ health & care informatics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. Article
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

12 authors.

Kate HoneyfordDivision of Clinical Studies, Institute of Cancer Research, Sutton, London, UK.ORCID http://orcid.org/0000-0002-5533-7693
Alf TimneyDivision of Clinical Studies, Institute of Cancer Research, Sutton, London, UK.
Runa LazzarinoNuffield Department of Primary Care and Health Sciences, University of Oxford, Oxford, UK.
John WelchCritical Care Department, University College Hospital, London, UK.
Andrew Jonathan BrentOxford University Hospitals NHS Foundation Trust, Oxford, UK.ORCID http://orcid.org/0000-0002-5349-0723
Anne KinderlererSt Mary's Hospital, London, UK.
Peter GhazalCardiff University, Cardiff, UK.
Anthony C GordonImperial College London, London, UK.ORCID http://orcid.org/0000-0002-0419-547X
Shashank PatilChelsea and Westminster NHS Foundation Trust, London, UK.
Graham CookeDepartment of Infectious Disease, School of Medicine, Imperial College, London, UK.
DiAlS Co-Investigators
Ceire E CostelloeDivision of Clinical Studies, Institute of Cancer Research, Sutton, London, UK ceire.costelloe@icr.ac.uk.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe National Health Service (NHS) 'move to digital' incorporating electronic patient record systems (EPR) facilitates the translation of paper-based screening tools into digital systems, including digital sepsis alerts. We evaluated the impact of sepsis screening tools on in-patient 30-day mortality across four multi-hospital NHS Trusts, each using a different algorithm for early detection of sepsis.

methodsUsing quasi-experimental methods, we investigated the impact of the screening tools. Individual-level EPR data for 718 000 patients between 2010 and 2020 were extracted to assess the impact on a target cohort and control cohort using interrupted time series analysis, based on a binomial regression model. We included one Trust which uses a paper-based screening tool to compare the impact of digital and paper-based interventions, and one Trust which did not introduce a sepsis screening tool, but did introduce an EPR.

resultsAll Trusts had lower odds of mortality, between 5% and 12%, after the introduction of the sepsis screening tool, before adjustment for pre-existing trends or patient casemix. After adjustment for existing trends, there was a significant reduction in mortality in two of the three Trusts which introduced sepsis screening tools. We also observed age-specific effects across Trusts.

conclusionOur findings confirm that patients with similar profiles have a lower mortality risk, consistent with our previous work. This study, conducted across multiple NHS Trusts, suggests that alerts could be tailored to specific patient groups based on age-related effects. Different Trusts may require unique indicators, thresholds, actions and treatments. Including additional EPR information could further enhance personalised care.

Indexed as

Electronic Health RecordsMass ScreeningSepsisAgedAged, 80 and overFemaleHumansMaleMiddle AgedState MedicineUnited KingdomDecision Support Systems, ClinicalElectronic Health RecordsEmergency Service, Hospital

Identifiers

PMID40288808
PMCPMC12035476

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.