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Advancing Patient Care with NEWS2

Improving healthcare monitoring through the updated NEWS2 system.

Chris Plummer, Madison Milne-Ives, Cen Cong, Lynsey Threlfall, Edward Meinert

― 7 min read


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In healthcare, keeping an eye on Patients is super important. One way to do this is through a system called the National Early Warning Score, or NEWS. This system helps doctors and nurses spot when a patient's Health is starting to go downhill. There’s a newer version called NEWS2, which aims to do the same but with some tweaks. Think of it as upgrading from a flip phone to a smartphone — it’s still a phone but with added features to make life easier.

The Use of NEWS2

The second version, NEWS2, is a popular tool that helps track patient conditions. It’s been shown to lower the chance of patients dying in the hospital. By scoring various health signs, it helps medical staff communicate better and act quickly when a patient needs attention. However, like everything in life that sounds great, it has some quirks. For instance, it doesn't always predict problems accurately, especially if you peek beyond a day into the future.

Imagine trying to guess who will win a sports game based on just the first quarter — you might be right sometimes, but not always. That's how NEWS2 works when predicting health issues beyond 24 hours.

The Role of Technology in Improving Health Monitoring

Now, here's where things get interesting. With all the technology we have today, like smartphones and computers, there's a chance we can make NEWS2 even better. By using more regularly collected Data about patients, we could improve how well it predicts problems. Some fancy artificial intelligence can also dive into this data and help healthcare workers make better choices. After all, using paper notes in today's digital age is like using a horse and carriage in a world full of cars.

Specific Needs for Older Adults

As we age, our bodies can act a bit like an old car that occasionally requires extra care. Older adults are more sensitive to sudden health changes. Unfortunately, they weren’t really considered when NEWS2 was being put together. It’s like trying to bake cookies without knowing that one of the ingredients is missing — you might still get cookies, but they won’t be as good as they could be. Enhancing NEWS2 for older patients could lead to better health results for this growing group.

How Effective is NEWS2?

In tests involving the earlier version of NEWS, the accuracy was quite steady across different groups of patients. However, the NEWS2 version doesn’t always do as well. Some patients, especially those at risk for certain breathing issues, might not get the accurate predictions they need. This inconsistency shows that perhaps we need to look deeper and consider personal patient details. It’s a bit like trying on shoes without considering your foot size — what fits one might not fit another.

Looking for Improvements

To figure out how to make NEWS2 better, researchers have been busy scouring various databases, like PubMed and Cochrane Library, for any clues. They gathered information about what might help, such as demographics like age and ethnicity, trends in health data, and changing how we score patients based on their needs. It’s like conducting a treasure hunt for lost wisdom to enhance this health tool!

The Big Plan

The main goal here is to create an advanced version of NEWS2. Here’s what researchers want to do:

  1. Collect Extra Info: They want to find out what other variables can improve how we spot problems in patients, particularly those known to NEWS2.

  2. Create a Big Dataset: They’re striving to gather a massive amount of patient information, linking all sorts of health observations with what happens to patients down the line.

  3. Train AI Models: Using this data, they’ll teach AI to identify which factors matter most in predicting health declines.

  4. Test the New Model: Importantly, they’ll check how accurate the new system is. After all, who wants to rely on a weather app that can't even tell you if it’s raining?

  5. Making It Work Everywhere: Lastly, they want to find out how this new system can be rolled out in various health settings, whether they’re equipped with modern tech or styling it old-school with paper records.

The Study Design

The researchers are diving into past patient data from the Newcastle upon Tyne Hospitals. This historical data will allow them to see how patients did over nearly seven years. To keep the project grounded, they’ll involve real people in discussions through patient and public involvement efforts. Including the opinions of older adults will ensure that their views are taken into account during this research.

Data Collection and Analysis

The plan involves gathering a mountain of patient data, including health observations, demographic details, and the outcomes of care. The information collected will help identify which variables might be the magical key to predicting declines in health more accurately. With the support of the Newcastle Hospitals’ information system, they will ensure all data remains anonymous and secure.

Algorithm Improvement

Once the researchers have gathered this data, they will sort it into training and testing groups. The algorithm will be trained to find the best predictors of serious health issues like severe infections or heart problems. This is akin to teaching a dog to fetch — you have to train it first to get it right. The goal is to show that this new system can indeed work better than its predecessor.

Testing in the Real World

As the research progresses, the newly developed tool will be tested on patient data from other hospitals to see if it works well in various settings. The ultimate goal is to implement this enhanced system across the UK and beyond, so healthcare professionals around the world can benefit from it.

Expected Outcomes

By April 2025, the researchers hope to have a new algorithm that enhances the NEWS2 scoring system, especially for predicting health risks over longer periods and among specific patient groups. If successful, this could help caregivers focus on patients who are at risk of declining in health and improve their chances of recovery.

Imagine if you could wave a magic wand that would give you a heads-up about who might need extra care; that’s the idea behind refining this scoring system!

Collaboration and Outreach

For any new health tool to gain acceptance, it must cater to diverse populations. Older people shouldn’t just be an afterthought; they need to be part of the conversation. Recently, there’s been talk about creating new tools for tracking children's health as well, showcasing the need for a variety of early warning systems.

Moreover, given that many hospitals still rely on traditional paperwork, the aim is to develop a system that can be implemented in both high-tech and low-tech environments. Whether through a paper system or a user-friendly app, the focus is on improvements that can benefit everyone.

Ethics and Sharing Findings

The researchers have submitted their project for ethical review, ensuring all bases are covered before they dive headfirst into the research. Once findings are available, they plan to share them widely through various means to reach as many people as possible. Collaboration is key; it’s essential for healthcare professionals and policymakers to connect and support each other in this area.

Conclusion

The ongoing quest to improve the National Early Warning Score system is all about making healthcare safer and smarter. By honing in on what can improve early detection of health deterioration, the hope is to better manage patient care. With technology, data, and a community-focused approach, the future of patient monitoring looks brighter than ever. Here’s to hoping that when it comes to healthcare, the goal is always to stay one step ahead!

Original Source

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

Abstract: IntroductionThe 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 analysisThis 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 disseminationThe 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 studyO_ST_ABSStrengthsC_ST_ABS- This work highlights the importance of investigating the use of additional clinical variables to those used in NEWS2, in the development of a new early warning score - The study design was informed by an evidence synthesis of the literature Limitations- Some retrospective data sets may be of low quality and/or incomplete - External validation will be needed to test algorithm generalisability

Authors: Chris Plummer, Madison Milne-Ives, Cen Cong, Lynsey Threlfall, Edward Meinert

Last Update: 2024-12-11 00:00:00

Language: English

Source URL: https://www.medrxiv.org/content/10.1101/2024.12.10.24318795

Source PDF: https://www.medrxiv.org/content/10.1101/2024.12.10.24318795.full.pdf

Licence: https://creativecommons.org/licenses/by/4.0/

Changes: This summary was created with assistance from AI and may have inaccuracies. For accurate information, please refer to the original source documents linked here.

Thank you to medrxiv for use of its open access interoperability.

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