Algorithm Refinement of the National Early Warning Score 2 (NEWS2): Study Protocol

Introduction

The second iteration of the National Early Warning Score (NEWS2) has been widely adopted for predicting patient deterioration in healthcare settings using routinely collected physiological observations. The use of NEWS2 has been shown to reduce in-hospital mortality, but it has limited accuracy in the prediction of clinically important outcomes, especially over longer time periods. The increasing implementation of digital patient observations and health records presents an opportunity to investigate whether the addition of individual patient characteristics and information about their care-setting, would improve the predictive accuracy of the score.

Methods and analysis

This protocol describes the work to determine whether the performance of the current NEWS2 system could be improved by the use of additional variables. The project has been designed after an extensive scoping review of existing literature on NEWS2 and an exploration of retrospective cohort data in The Newcastle upon Tyne Hospitals NHS Foundation Trust, with input from key clinical stakeholders.

Ethics and dissemination

The project has received competitive funding following peer-review, from the NIHR Newcastle Biomedical Research Centre as an Interdisciplinary Research Award. Ethical approval has been requested. Findings are expected to be produced by June 2025, and will be disseminated at symposia, conferences and in journal publications.

Strengths and limitations of this study