Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK.
Centre for Health Technology, School of Nursing and Midwifery, University of Plymouth, Plymouth, PL4 6DN, UK.
BMJ Open. 2024 Oct 9;14(10):e089061. doi: 10.1136/bmjopen-2024-089061.
The National Early Warning Score (NEWS/2) system was developed to enable the detection and early intervention of patients at risk of clinical deterioration. It has demonstrated good accuracy in identifying imminent critical outcomes but has limitations in its applicability to various patient types and its ability to predict upcoming deterioration beyond 24 hours. Various studies have attempted to improve its predictive accuracy and clinical utility by modifying or adding variables to the standard NEWS/2 system. The purpose of this scoping review is to identify modifications to the NEWS and NEWS2 systems (eg, the inclusion of additional patient demographic, physiological or other characteristics) and how those modifications influence predictive accuracy to provide an evidence base for subsequent improvement of the system.
The review will be structured using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews and the Population, Intervention, Comparator, Outcome, and Study frameworks. Six databases (PubMed, ScienceDirect, Embase, CINAHL, Web of Science and Cochrane Library) will be searched in April 2024 for articles published in English. Article screening and data extraction will be conducted by two independent reviewers, with any conflicts resolved by discussion. The analysis will be descriptive to provide a summary of modifications identified and their influence on the predictive accuracy of NEWS/NEWS 2.
Ethical approval is not required as data will be obtained from already published sources. Findings from this study will be disseminated via publication in a peer-reviewed journal.
国家早期预警评分（NEWS/NEWS2）系统旨在发现有临床恶化风险的患者，并进行早期干预。该系统在识别即将发生的危急结果方面具有良好的准确性，但在适用于各种患者类型和预测 24 小时后即将发生的恶化方面存在局限性。各种研究试图通过修改或向标准的 NEWS/NEWS2 系统添加变量来提高其预测准确性和临床实用性。本范围综述的目的是确定对 NEWS 和 NEWS2 系统的修改（例如，纳入额外的患者人口统计学、生理学或其他特征），以及这些修改如何影响预测准确性，为系统的后续改进提供证据基础。
该综述将使用系统评价和荟萃分析扩展的首选报告项目以及人群、干预、比较、结果和研究框架进行构建。2024 年 4 月将在六个数据库（PubMed、ScienceDirect、Embase、CINAHL、Web of Science 和 Cochrane Library）中搜索以英语发表的文章。文章筛选和数据提取将由两名独立的评审员进行，任何冲突都将通过讨论解决。分析将是描述性的，以总结所确定的修改及其对 NEWS/NEWS2 预测准确性的影响。
由于数据将从已发表的来源中获得，因此不需要伦理批准。本研究的结果将通过在同行评议期刊上发表来传播。
