Re: cross-sectional audit on the relevance of Elevated National Early Warning Score in medical patients at a Model 2 hospital in Ireland

Excerpt

The article by Lobo et al. [1] has the potential to produce confusion surrounding the use of the terms ‘National Early Warning Score’ and ‘NEWS’. Similar confusion elsewhere in the literature has beset research into the Modified Early Warning Score (MEWS), where numerous ‘alternative’ iterations have been described, each inappropriately using the generic term ‘MEWS’ [2]. The early warning score used throughout Ireland is actually the VitalPAC Early Warning Score (ViEWS) [3] and not NEWS [4, 5]. Table 2 of the paper by Lobo et al. [1] describes the weightings of ViEWS, not NEWS. There are several differences in the weighting bands of the physiological variables used in the two systems (specifically, for supplemental oxygen, pulse and BP), which inevitably have an impact on the sensitivity/specificity of the two systems. ViEWS allocates three points for patients receiving supplemental oxygen, rather than the two points assigned in NEWS. It follows that those receiving supplemental oxygen are more likely to trigger with ViEWS than with NEWS. …