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. 2018 Oct;18(5):371-373.
doi: 10.7861/clinmedicine.18-5-371.

NEWS 2 - too little evidence to implement?

Luke E Hodgson  1 , Jo Congleton  2 , Richard Venn  3 , Lui G Forni  4 , Paul J Roderick  5
Affiliations

NEWS 2 - too little evidence to implement?

Luke E Hodgson et al. Clin Med (Lond). 2018 Oct.

Abstract

The Royal College of Physicians (RCP) recently published the National Early Warning Score 2 (NEWS2), aiming to improve safety for patients with hypercapnic respiratory failure by suggesting a separate oxygen saturation (SpO2) parameter scoring system for such patients. A previously published study of patients (n=2,361 admissions) with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) demonstrated alternative scoring systems at admission did not outperform the original NEWS. Applying NEWS2 SpO2 parameters to this previously described cohort would have resulted in 44% (n=27/62) of patients who scored ≥7 points on the original NEWS and subsequently died being placed in a lower call-out threshold. NEWS2 loses the benefits of a unified, standardised scoring system and we suggest prospective research in this area before applying this adjustment.

Keywords: Chronic obstructive pulmonary disease; National Early Warning Score 2; validation study.

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Figures

Fig 1.
Fig 1.
RCP NEWS and NEWS2 SpO2 scoring. Top panel – original NEWS; bottom panel– NEWS2. Reproduced with permission from the Royal College of Physicians, London.
Fig 2.
Fig 2.
Call-out thresholds and frequency of observations and suggested seniority of responder. Reproduced with permission from the Royal College of Physicians, London. ICU = intensive care unit
See this image and copyright information in PMC

Comment in

References

    1. Royal College of Physicians National Early Warning Score (NEWS) Standardising the assessment of acute-illness severity in the NHS. London: RCP; 2012.
    1. Eccles SR. Subbe C. Hancock D. Thomson N. CREWS: improving specificity whilst maintaining sensitivity of the National Early Warning Score in patients with chronic hypoxaemia. Resuscitation. 2014;85:109–11. - PubMed
    1. O'Driscoll BR. Bakerly ND. Murphy P, et al. Concerns regarding the design of the bedside monitoring chart for use with the NEWS (National Early Warning System) Clin Med. 2013;13:319–20. - PMC - PubMed
    1. Hodgson LE. Dimitrov BD. Congleton J, et al. A validation of the National Early Warning Score to predict outcome in patients with COPD exacerbation. Thorax. 2017;72:23–30. - PubMed
    1. Royal College of Physicians National Early Warning Score (NEWS) 2: Standardising the assessment of acute-illness severity in the NHS. Updated report of a working party. London: RCP; 2017.

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