Predicting mortality (routine practice cut-offs (qSOFA ≥2 and NEWS ≥5))
| Score | Author, year, reference | Sensitivity % (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 ≥2 | Goulden 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 ≥1 | Goulden 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 ≥5 | Goulden 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 ≥6 | Szakmany 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 ≥7 | Churpek† 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 ≥8 | de 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 ≥5 | Churpek† 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 ≥7 | de 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.