The Resource Early warning system scores : a systematic review, prepared for Department of Veterans Affairs, Veterans Health Administration, Health Services Research & Development Service ; prepared by Evidence-based Synthesis Program (ESP) Center, Portland VA Medical Center ; principal Investigator, M.E. Beth Smith ; co-investigators, Joseph C. Chiovaro [and six others]

Early warning system scores : a systematic review, prepared for Department of Veterans Affairs, Veterans Health Administration, Health Services Research & Development Service ; prepared by Evidence-based Synthesis Program (ESP) Center, Portland VA Medical Center ; principal Investigator, M.E. Beth Smith ; co-investigators, Joseph C. Chiovaro [and six others]

Label
Early warning system scores : a systematic review
Title
Early warning system scores
Title remainder
a systematic review
Statement of responsibility
prepared for Department of Veterans Affairs, Veterans Health Administration, Health Services Research & Development Service ; prepared by Evidence-based Synthesis Program (ESP) Center, Portland VA Medical Center ; principal Investigator, M.E. Beth Smith ; co-investigators, Joseph C. Chiovaro [and six others]
Title variation
QUERI
Creator
Contributor
Author
Issuing body
Subject
Genre
Language
eng
Summary
Background: Recognizing early signs of clinical deterioration of hospitalized patients is thought to improve patient outcomes by activating more attentive care in a timely fashion. Early warning system scores are tools used by care teams to potentially predict a patient's risk of deterioration and facilitate changes in management. Objective: To systematically review the evidence on the predictive ability of Early Warning System (EWS) scores and the impact of EWS interventions on health and resource related outcomes. Data Sources: MEDLINE, CINAHL, and Cochrane Library through April 2013 and hand search of reference lists. Study Selection: Independent dual review to identify English language studies of early warning systems tested with adult patients admitted to medical or surgical wards. Non-systematic reviews, opinions, and case series were excluded. Data Extraction: Data were extracted by 2 reviewers on the population, setting, sample size, duration, model discrimination and calibration, health outcomes, and resource utilization. Quality was assessed as applicable using a modified version of the Quality in Prognosis Studies (QUIPS) assessment tool for observational studies. For predictive ability, primary outcomes were model discrimination on 48-hour mortality, cardiac arrest, or pulmonary arrest. Outcomes for impact of EWS implementation included 30-day mortality, cardiovascular events, use of vasopressors, number of ventilator days, respiratory failure, and resource utilization. Results: Of 13,595 citations reviewed, 17 studies of 11 unique models met criteria. All were based on some combination of vital signs and clinical evaluation. Six observational studies tested in large urban hospitals in developed countries found a strong predictive value for death (AUROC 0.88-0.93) and cardiac arrest (AUROC 0.77-0.86) within 48 hours. Eleven observational cohort studies with historical controls provided evidence on the impact of EWS implementation but were insufficient to draw firm conclusions due to methodological limiitations. Conclusions and Relevance: Current early warning system scores perform well for predicting cardiac arrest and death within 48 hours although the impact on health outcomes and utilization of resources remains uncertain. Efforts to more rigorously assess their performance and effectiveness are needed as use becomes more widespread
Member of
Cataloging source
NLM
http://library.link/vocab/creatorName
Smith, M. E. Beth
Government publication
federal national government publication
Illustrations
illustrations
Index
no index present
Literary form
non fiction
Nature of contents
  • dictionaries
  • bibliography
NLM call number
WX 150.1
http://library.link/vocab/relatedWorkOrContributorName
  • Chiovaro, Joseph C.
  • United States
  • Portland VA Medical Center
  • Quality Enhancement Research Initiative (U.S.)
Series statement
Evidence-based synthesis program
http://library.link/vocab/subjectName
  • Hospital Communication Systems
  • Patient Acuity
  • Critical Care
  • Medical Audit
  • Time Factors
Label
Early warning system scores : a systematic review, prepared for Department of Veterans Affairs, Veterans Health Administration, Health Services Research & Development Service ; prepared by Evidence-based Synthesis Program (ESP) Center, Portland VA Medical Center ; principal Investigator, M.E. Beth Smith ; co-investigators, Joseph C. Chiovaro [and six others]
Instantiates
Publication
Note
"January 2014."
Bibliography note
Includes bibliographical references
Carrier category
online resource
Carrier category code
cr
Carrier MARC source
rdacarrier
Content category
  • text
  • still image
Content type code
  • txt
  • sti
Content type MARC source
  • rdacontent
  • rdacontent
Control code
904423895
Extent
1 online resource (iii, 39 pages)
Form of item
online
Media category
computer
Media MARC source
rdamedia
Media type code
c
Other physical details
illustrations.
Specific material designation
remote
System control number
(OCoLC)904423895
Label
Early warning system scores : a systematic review, prepared for Department of Veterans Affairs, Veterans Health Administration, Health Services Research & Development Service ; prepared by Evidence-based Synthesis Program (ESP) Center, Portland VA Medical Center ; principal Investigator, M.E. Beth Smith ; co-investigators, Joseph C. Chiovaro [and six others]
Publication
Note
"January 2014."
Bibliography note
Includes bibliographical references
Carrier category
online resource
Carrier category code
cr
Carrier MARC source
rdacarrier
Content category
  • text
  • still image
Content type code
  • txt
  • sti
Content type MARC source
  • rdacontent
  • rdacontent
Control code
904423895
Extent
1 online resource (iii, 39 pages)
Form of item
online
Media category
computer
Media MARC source
rdamedia
Media type code
c
Other physical details
illustrations.
Specific material designation
remote
System control number
(OCoLC)904423895

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