Evaluating the performance of the National Early Warning Score in different diagnostic groups

Connor Price*, David Prytherch, Ina Kostakis, Jim Briggs

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Background: The National Early Warning Score (NEWS) is used in hospitals across the UK to detect deterioration of patients within care pathways. It is used for most patients, but there are relatively few studies validating its performance in groups of patients with specific conditions.

Methods: The performance of NEWS was evaluated against 36 other Early Warning Scores, in 123 patient groups, through use of the area under the receiver operating characteristic (AUROC) curve technique, to compare the abilities of each Early Warning Score to discriminate an outcome within 24hrs of vital sign recording. Outcomes evaluated were death, ICU admission, or a combined outcome of either death or ICU admission within 24 hours of an observation set.

Results: The National Early Warning Score 2 performs either best or joint best within 120 of the 123 patient groups evaluated and is only outperformed in prediction of unanticipated ICU admission. When outperformed by other Early Warning Scores in the remaining 3 patient groups, the performance difference was marginal.

Conclusions: Consistently high performance indicates that NEWS is a suitable early warning score to use for all diagnostic groups considered by this analysis, and patients are not disadvantaged through use of NEWS in comparison to any of the other evaluated Early Warning Scores.
Original languageEnglish
Article number110032
Number of pages8
Early online date3 Nov 2023
Publication statusPublished - 1 Dec 2023


  • Adverse events
  • Early warning scores
  • Intensive care unit admission
  • Mortality
  • Rapid response systems

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