Table 5

Predicting mortality (routine practice cut-offs (qSOFA ≥2 and NEWS ≥5))

ScoreAuthor, year, referenceSensitivity % (95% CI)Specificity %
(95% CI)
Positive predictive value % (95% CI)Negative predictive value % (95% CI)Positive likelihood ratio (95% CI)Negative likelihood ratio (95% CI)
qSOFA ≥2Goulden et al, 201820 37.0
(31-43)
79.0
(77-81)
23.0
(19-28)
88.0
(86-90)
1.78
(1.48 to 2.14)
0.80
(0.72 to 0.88)
Churpek† et al, 201721 71.13
(68.1 to 74)
63.51
(62.4 to 63.9)
9.2
(8.5 to 9.9)
97.7
(97.4 to 97.9)
1.93
(1.84 to 2.02)
0.46
(0.41 to 0.51))
Usman et al‡, 201822 43.3
(35.3 to 51.7)
Sepsis related
98.7
(98.6 to 98.8)
Sepsis related
5.2
(4.1 to 6.5)
99.9
(99.9 to 99.9)
33.31
(27.93 to 40.96)
0.57
(0.50 to 0.66)
Szakmany et al, 201823 22.0
(14 to 33)
89.0
(85 to 92)
34.0
(22 to 49)
82.0
(77 to 85)
1.99
(1.17 to 3.39)
0.88
(0.78 to 0.99)
Samsudin§ et al, 201824 37.5
(22.5 to 52.5)
93.1
(89.3 to 96.9)
55.5*
(37.3 to 72.4)
86.6*
(81 to 90.8)
5.44
(2.76 to 10.69)
0.67
(0.53 to 0.86)
de Groot et al, 201725 32.0
(30 to 33)
87.0
(85 to 88)
11.0
(10 to 12)
95.0
(94 to 96)
2.46
(1.89 to 3.2)
0.78
(0.70 to 0.88)
Redfern et al, 201826 13.6
(12.8 to 14.5)
99.3
(99.3 to 99.4)
64.8*
(61.2 to 68.3)
92.9*
(92.6 to 93.1)
19.43
(17.98 to 24.35)
0.87
(0.86 to 0.88)
Redondo-González et al, 201827 65
(51 to 77)
58
(50 to 66)
36
(27 to 46)
82
(73 to 88)
1.55
(1.25 to 1.92)
0.60
(0.44 to 0.83)
Van der Woude et al, 201831 33.3
(14.6 to 57)
96.4
(94.5 to 97.8)
25.9*
(13.1 to 44.6)
97.5*
(95.8 to 98.5)
9.25
(4.40 to 19.43)
0.69
(0.51 to 0.94)
Brink et al, 201932 28.5
(24.7 to 32.7)
93.7
(93.1 to 94.2)
22.3*
(19.2 to 25.7)
95.4*
(94.9 to 95.8)
4.52*
(3.84 to 5.33)
0.76*
(0.72 to 0.81)
qSOFA ≥1Goulden et al, 201820 77.0
(0.72 to 0.82)
41
(0.39 to 0.44)
18.2*
(16.1 to 20.6)
91.3*
(88.9 to 93.1)
1.31
(1.21 to 1.41)
0.56
(0.45 to 0.71)
Churpek† et al, 201721 98.2
(97.1 to 98.9)
9.9
(9.5 to 10.4)
5.4*
(5.1 to 5.7)
99.1*
(98.5 to 99.4)
1.09
(1.08 to 1.10)
0.18
(0.11 to 0.29)
Usman et al, 201822 83.3
(76.6 to 88.4)
Sepsis related
86.7
(86.5 to 87)
Sepsis related
1.0
(0.8 to 1.2)
100
(100-100)
6.26
(5.84 to 6.77)
0.19
(0.13 to 0.28)
Samsudin et al, 201824 67.5
(53.0 to 82.0)
64.4
(57.3 to 71.5)
30.4*
(21.8 to 40.6)
89.6*
(83 to 93.8)
1.90
(1.41 to 2.54)
0.51
(0.32 to 0.80)
de Groot et al, 201725 83.0
(81-84)
47.0
(44-49)
10
(9-11)
98
(97-98)
1.57
(1.44 to 1.70)
0.36
(0.25 to 0.52)
Redfern et al, 201826 48.1
(46.8 to 49.5)
85.6
(85.3 to 86.0)
22.8*
(21.8 to 23.8)
94.9*
(94.7 to 95.2)
3.36
(3.21 to 3.50)
0.61
(0.59 to 0.63)
Redondo-González et al, 201827 98
(89-99)
14
(9-21)
29
(22-36)
95
(77-99)
1.14
(1.08 to 1.21)
0.14
(0.03 to 0.71)
Brink et al, 201932 69.9
(65.7 to 73.8)
59.5
(58.4 to 60.6)
9.9*
(8.9 to 10.9)
96.9*
(96.4 to 97.3)
1.73*
(1.62 to 1.84)
0.51
(0.44 to 0.58)
NEWS ≥5Goulden et al, 201820 74.0
(68 to 79)
43.0
(41 to 46)
18.0
(16 to 21)
91.0
(88 to 93)
1.30
(1.19 to 1.41)
0.61
(0.55 to 0.61)
Churpek† et al, 201721 97.3
(96 to 98)
21.5
(20.9 to 22.1)
6.1*
(5.7 to 6.5)
99.4*
(99 to 99.6)
1.24
(1.22 to 1.26)
0.13
(0.08 to 0.18))
Usman et al‡, 201822 87.9
(81.5 to 92.3)
Sepsis related
90.2
(90 to 90.4)
Sepsis related
1.4
(1.2 to 1.6)
100
(100-100)
8.97
(7.18 to 11.20)
0.13
(0.09 to 0.20)
Samsudin§ et al, 201824 85.0
(73.9 to 96.1)
39.7
(32.4 to 46.9)
24.5*
(18.1 to 32.2)
92.0*
(83.6 to 96.3)
1.41
(1.18 to 1.68)
0.38
(0.18 to 0.81)
Redfern et al, 201826 50.5
(49.3 to 51.7)
90.9
(90.7 to 91.2)
32.9*
(31.6 to 34.2)
95.4*
(95.2 to 95.6)
5.55
(5.31)
0.55
(0.53 to 0.56)
Brink et al, 201932 83.0
(79.4 to 86.1)
42.5
(41.4 to 43.6)
8.4*
(7.7 to 9.2)
97.5
(96.9 to 98.0)
1.44*
(1.38 to 1.51)
0.40*
(0.33 to 0.49)
NEWS ≥6Szakmany et al, 201823 41.0
(30 to 53)
73.0
(67 to 77)
30.0
(26 to 35)
70.0
(65 to 74)
1.48
(1.02 to 2.16)
0.81
(0.67 to 0.98)
NEWS ≥7Churpek† et al, 201721 90.9
(88.8 to 92.6)
46.1
(45.3 to 46.8)
8.1*
(7.6 to 8.6)
99.0*
(98.7 to 99.2)
1.69
(1.64 to 1.73)
0.20
(0.16 to 0.24)
Samsudin§ et al, 201824 62.5
(47.5 to 77.5)
71.3
(64.5 to 78)
33.4*
(23.7 to 44.6)
89.2*
(83 to 93.4)
2.18
(1.56 to 3.05)
0.53
(0.35 to 0.79)
Redfern et al, 201826 30.4
(29.3 to 31.6)
97.7
(97.6 to 97.8)
53.7*
(51.4 to 55.9)
94.1*
(93.9 to 94.3)
13.22
(12.11 to 14.31)
0.71
(0.70 to 0.73)
Redondo-González et al, 201827 92
(80 to 96)
41
(33 to 49)
35
(27 to 43)
93
(84 to 97)
1.56
(1.38 to 1.76)
0.20
(0.09 to 0.42)
Brink et al, 201932 68.0
(63.7 to 72.0)
66.5
(65.4 to 67.5)
11.4*
(10.3 to 12.6)
97.0
(96.5 to 97.5)
2.03*
(1.90 to 2.17)
0.48*
(0.42 to 0.55)
NEWS ≥8de Groot et al, 201725 63.0
(61-65)
63.0
(61-65)
10.0
(8-11)
96.0
(95-97)
1.70
(1.48 to 1.95)
0.59
(0.47 to 0.73)
MEWS ≥5Churpek† et al, 201721 75.4
(72.5 to 78)
62.4
(61.7 to 63.1)
9.5*
(8.8 to 10.2)
98.0*
(97.7 to 98.2)
2.01
(1.92 to 2.09)
0.39
(0.35 to 0.44)
Samsudin§ et al, 201824 45.0
(29.6 to 60.4)
62.1
(54.9 to 69.3)
21.4*
(14 to 31.4)
83.1*
(75.7 to 88.6)
1.19
(0.80 to 1.76)
0.89
(0.65 to 1.2)
van der Woude et al, 201831 23.8
(8.2 to 47.2)
87
(83.9 to 89.7)
6.5*
(2.8 to 14.3)
96.8*
(94.9 to 98)
1.83
(0.83 to 4.06)
0.876
(0.69 to 1.12)
MEWS ≥7de Groot et al, 201725 42
(40 to 44)
77
(76 to 79)
11
(10 to 13)
95
(94 to 96)
1.83
(1.48 to 2.25)
0.75
(0.65 to 0.87)
  • *Calculated values

  • †ED data only. Supplemental data sent by authors of this study.

  • ‡PPV and NPV calculated from 2×2 tables sent by authors.

  • §Data from supplemental data sent by authors of this study.

  • AUROC, area under the receiver operating characteristic curve; MEWS, Modified Early Warning Score; ND, no data; NEWS, National Early Warning Score; NG, not given; PPV/NPV, positive and negative predictive values; qSOFA, Quick Sequential Organ Failure Assessment.