Review and performance evaluation of aggregate weighted 'track and trigger' systems

This source preferred by Gary Smith

Authors: Smith, G.B., Prytherch, D.R., Schmidt, P.E. and Featherstone, P.I.

http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T19-4RRXJC7-2&_user=1682380&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000011378&_version=1&_urlVersion=0&_userid=1682380&md5=96e74390c5cd8b1050cbb312e40030a7

Journal: Resuscitation

Volume: 77

Pages: 170-179

ISSN: 0300-9572

DOI: 10.1016/j.resuscitation.2007.12.004

Objectives There is no up-to-date literature review of physiologically based, aggregate weighted ‘track and trigger’ systems (AWTTS) and few data on their predictive ability for serious adverse outcomes. The aim of this study was to describe the AWTTS in clinical use and assess their ability to discriminate between survivors and non-survivors of hospital admission, based on an initial set of vital signs.

Materials and methods A systematic review of the literature was performed, to describe the AWTTS, their components and their differences. Their ability to discriminate between survivors and non-survivors was evaluated using the area under the receiver-operating characteristics (AUROC) curve, and a database of 9987 vital signs datasets.

Results A total of 33 unique AWTTS were identified with AUROC (±95% CI) ranging from 0.657 (0.636–0.678) to 0.782 (0.767–0.797). 12 AWTTS (36%) discriminated reasonably well between survivors and non-survivors, the top four performing AWTTS incorporated age as a component (AUROCs ranging from 0.722 to 0.782). The top two systems also incorporated temperature.

Conclusions There is a wide range of unique, but very similar, AWTTS in clinical use. There is no consistency regarding their physiological components, but the majority differ only in minor variations in the weightings for physiological derangement and/or the cut-off points between physiological weighting bands. The performance of most systems tested was poor when used to discriminate between survivors and non-survivors, although 36% discriminated reasonably well. Our results suggest that physiology can be used to predict outcome, but that further work is required to improve the AWTTS models.

This data was imported from PubMed:

Authors: Smith, G.B., Prytherch, D.R., Schmidt, P.E. and Featherstone, P.I.

Journal: Resuscitation

Volume: 77

Issue: 2

Pages: 170-179

ISSN: 0300-9572

DOI: 10.1016/j.resuscitation.2007.12.004

OBJECTIVES: There is no up-to-date literature review of physiologically based, aggregate weighted 'track and trigger' systems (AWTTS) and few data on their predictive ability for serious adverse outcomes. The aim of this study was to describe the AWTTS in clinical use and assess their ability to discriminate between survivors and non-survivors of hospital admission, based on an initial set of vital signs. MATERIALS AND METHODS: A systematic review of the literature was performed, to describe the AWTTS, their components and their differences. Their ability to discriminate between survivors and non-survivors was evaluated using the area under the receiver-operating characteristics (AUROC) curve, and a database of 9987 vital signs datasets. RESULTS: A total of 33 unique AWTTS were identified with AUROC (+/-95% CI) ranging from 0.657 (0.636-0.678) to 0.782 (0.767-0.797). 12 AWTTS (36%) discriminated reasonably well between survivors and non-survivors, the top four performing AWTTS incorporated age as a component (AUROCs ranging from 0.722 to 0.782). The top two systems also incorporated temperature. CONCLUSIONS: There is a wide range of unique, but very similar, AWTTS in clinical use. There is no consistency regarding their physiological components, but the majority differ only in minor variations in the weightings for physiological derangement and/or the cut-off points between physiological weighting bands. The performance of most systems tested was poor when used to discriminate between survivors and non-survivors, although 36% discriminated reasonably well. Our results suggest that physiology can be used to predict outcome, but that further work is required to improve the AWTTS models.

This data was imported from Scopus:

Authors: Smith, G.B., Prytherch, D.R., Schmidt, P.E. and Featherstone, P.I.

Journal: Resuscitation

Volume: 77

Issue: 2

Pages: 170-179

ISSN: 0300-9572

DOI: 10.1016/j.resuscitation.2007.12.004

Objectives: There is no up-to-date literature review of physiologically based, aggregate weighted 'track and trigger' systems (AWTTS) and few data on their predictive ability for serious adverse outcomes. The aim of this study was to describe the AWTTS in clinical use and assess their ability to discriminate between survivors and non-survivors of hospital admission, based on an initial set of vital signs. Materials and methods: A systematic review of the literature was performed, to describe the AWTTS, their components and their differences. Their ability to discriminate between survivors and non-survivors was evaluated using the area under the receiver-operating characteristics (AUROC) curve, and a database of 9987 vital signs datasets. Results: A total of 33 unique AWTTS were identified with AUROC (±95% CI) ranging from 0.657 (0.636-0.678) to 0.782 (0.767-0.797). 12 AWTTS (36%) discriminated reasonably well between survivors and non-survivors, the top four performing AWTTS incorporated age as a component (AUROCs ranging from 0.722 to 0.782). The top two systems also incorporated temperature. Conclusions: There is a wide range of unique, but very similar, AWTTS in clinical use. There is no consistency regarding their physiological components, but the majority differ only in minor variations in the weightings for physiological derangement and/or the cut-off points between physiological weighting bands. The performance of most systems tested was poor when used to discriminate between survivors and non-survivors, although 36% discriminated reasonably well. Our results suggest that physiology can be used to predict outcome, but that further work is required to improve the AWTTS models. © 2007 Elsevier Ireland Ltd. All rights reserved.

This data was imported from Web of Science (Lite):

Authors: Smith, G.B., Prytherch, D.R., Schmidt, P.L. and Featherstone, P.I.

Journal: RESUSCITATION

Volume: 77

Issue: 2

Pages: 170-179

ISSN: 0300-9572

DOI: 10.1016/j.resuscitation.2007.12.004

This data was imported from Europe PubMed Central:

Authors: Smith, G.B., Prytherch, D.R., Schmidt, P.E. and Featherstone, P.I.

Journal: Resuscitation

Volume: 77

Issue: 2

Pages: 170-179

eISSN: 1873-1570

ISSN: 0300-9572

OBJECTIVES: There is no up-to-date literature review of physiologically based, aggregate weighted 'track and trigger' systems (AWTTS) and few data on their predictive ability for serious adverse outcomes. The aim of this study was to describe the AWTTS in clinical use and assess their ability to discriminate between survivors and non-survivors of hospital admission, based on an initial set of vital signs. MATERIALS AND METHODS: A systematic review of the literature was performed, to describe the AWTTS, their components and their differences. Their ability to discriminate between survivors and non-survivors was evaluated using the area under the receiver-operating characteristics (AUROC) curve, and a database of 9987 vital signs datasets. RESULTS: A total of 33 unique AWTTS were identified with AUROC (+/-95% CI) ranging from 0.657 (0.636-0.678) to 0.782 (0.767-0.797). 12 AWTTS (36%) discriminated reasonably well between survivors and non-survivors, the top four performing AWTTS incorporated age as a component (AUROCs ranging from 0.722 to 0.782). The top two systems also incorporated temperature. CONCLUSIONS: There is a wide range of unique, but very similar, AWTTS in clinical use. There is no consistency regarding their physiological components, but the majority differ only in minor variations in the weightings for physiological derangement and/or the cut-off points between physiological weighting bands. The performance of most systems tested was poor when used to discriminate between survivors and non-survivors, although 36% discriminated reasonably well. Our results suggest that physiology can be used to predict outcome, but that further work is required to improve the AWTTS models.

The data on this page was last updated at 04:58 on April 25, 2019.