Development and validation of a decision tree early warning score based on routine laboratory test results for the discrimination of hospital mortality in emergency medical admissions
dc.contributor.author | Jarvis, S.W. | * |
dc.contributor.author | Kovacs, C. | * |
dc.contributor.author | Badriyah, T. | * |
dc.contributor.author | Briggs, J. | * |
dc.contributor.author | Mohammed, Mohammed A. | * |
dc.contributor.author | Meredith, P. | * |
dc.contributor.author | Schmidt, P.E. | * |
dc.contributor.author | Featherstone, P.I. | * |
dc.contributor.author | Prytherch, D.R. | * |
dc.contributor.author | Smith, G.B. | * |
dc.date.accessioned | 2016-10-07T15:33:59Z | |
dc.date.available | 2016-10-07T15:33:59Z | |
dc.date.issued | 2013-11 | |
dc.identifier.citation | Jarvis SW, Kovacs C, Badriyah T, Briggs J, Mohammed MA et al (2013) Development and validation of a decision tree early warning score based on routing laboratory test results for the discrimination of hospital mortality in emergency medical admissions. Resuscitation. 84(11): 1494-1499. | |
dc.identifier.uri | http://hdl.handle.net/10454/9783 | |
dc.description | No | |
dc.description.abstract | To build an early warning score (EWS) based exclusively on routinely undertaken laboratory tests that might provide early discrimination of in-hospital death and could be easily implemented on paper. Using a database of combined haematology and biochemistry results for 86,472 discharged adult patients for whom the admission specialty was Medicine, we used decision tree (DT) analysis to generate a laboratory decision tree early warning score (LDT-EWS) for each gender. LDT-EWS was developed for a single set (n=3496) (Q1) and validated in 22 other discrete sets each of three months long (Q2, Q3...Q23) (total n=82,976; range of n=3428 to 4093) by testing its ability to discriminate in-hospital death using the area under the receiver-operating characteristic (AUROC) curve. The data generated slightly different models for male and female patients. The ranges of AUROC values (95% CI) for LDT-EWS with in-hospital death as the outcome for the validation sets Q2-Q23 were: 0.755 (0.727-0.783) (Q16) to 0.801 (0.776-0.826) [all patients combined, n=82,976]; 0.744 (0.704-0.784, Q16) to 0.824 (0.792-0.856, Q2) [39,591 males]; and 0.742 (0.707-0.777, Q10) to 0.826 (0.796-0.856, Q12) [43,385 females]. CONCLUSIONS: This study provides evidence that the results of commonly measured laboratory tests collected soon after hospital admission can be represented in a simple, paper-based EWS (LDT-EWS) to discriminate in-hospital mortality. We hypothesise that, with appropriate modification, it might be possible to extend the use of LDT-EWS throughout the patient's hospital stay. | |
dc.relation.isreferencedby | http://dx.doi.org/10.1016/j.resuscitation.2013.05.018 | |
dc.subject | Adolescent | |
dc.subject | ; Adult | |
dc.subject | ; Aged | |
dc.subject | ; Algorithms | |
dc.subject | ; Decision trees | |
dc.subject | ; Diagnostic tests | |
dc.subject | ; Emergencies | |
dc.subject | ; Female | |
dc.subject | ; Hospital mortality | |
dc.subject | ; Humans | |
dc.subject | ; Male | |
dc.subject | ; Middle aged | |
dc.subject | ; Patient admission | |
dc.subject | ; Predictive value of tests | |
dc.subject | ; Biochemistry | |
dc.subject | ; Early warning scores | |
dc.subject | ; Haematology | |
dc.subject | ; Illness severity score | |
dc.subject | ; Risk prediction | |
dc.title | Development and validation of a decision tree early warning score based on routine laboratory test results for the discrimination of hospital mortality in emergency medical admissions | |
dc.status.refereed | Yes | |
dc.date.Accepted | 2013-05-24 | |
dc.date.application | 2013-05-31 | |
dc.type | Article | |
dc.type.version | No full-text available in the repository |