Evidence-Based Medicine
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Crit Care Med. Aug 4, 2018; 7(3): 39-45
Published online Aug 4, 2018. doi: 10.5492/wjccm.v7.i3.39
Validation of the VitalPAC Early Warning Score at the Intermediate Care Unit
Joost DJ Plate, Linda M Peelen, Luke PH Leenen, Falco Hietbrink
Joost DJ Plate, Luke PH Leenen, Falco Hietbrink, Division of Surgery, University Medical Centre Utrecht, Utrecht University, Utrecht 3584 CX, The Netherlands
Linda M Peelen, Julius Center for Health Sciences, University Medical Center Utrecht, Utrecht University, Utrecht 3584 CX, The Netherlands
Linda M Peelen, Departments of Anaesthesiology and Intensive Care Medicine, University Medical Center Utrecht, Utrecht University, Utrecht 3584 CX, The Netherlands
Author contributions: All authors contributed to this manuscript.
Conflict-of-interest statement: There are no conflicts of interest arising from this work.
Open-Access: This article is an open-access article, which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Joost DJ Plate, MD, MSc, Research Scientist, Division of Surgery, University Medical Centre Utrecht, Utrecht University, Heidelberglaan 100, Utrecht 3584 CX, The Netherlands. j.d.j.plate@umcutrecht.nl
Telephone: +31-88-7555555 Fax: +31-88-7555438
Received: March 20, 2018
Peer-review started: March 20, 2018
First decision: April 23, 2018
Revised: June 19, 2018
Accepted: June 26, 2018
Article in press: June 27, 2018
Published online: August 4, 2018
Processing time: 139 Days and 12.7 Hours
Core Tip

Core tip: This study used all the routinely collected Early Warning Scores (EWS) in every nursing shift from 2014 to 2016 (n = 9113) at the standalone Intermediate Care Unit to assess the performance and clinical relevance of the EWS to detect clinical deterioration amongst patients admitted in this critical care facility. It follows that although the discriminative performance was acceptable (AUC 0.72), the clinical relevance is limited as 19 false alarms were needed to detect one event. As this may result in alarm fatigue, its use in this setting should be reconsidered.