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Early warning systems (EWSs) are designed and deployed to create a rapid assessment and response for patients with clinical deterioration outside the intensive care unit (ICU). These models incorporate patient-level data such as vital signs and laboratory values to detect or prevent adverse clinical events, such as vital signs and laboratories to allow detection and prevention of adverse clinical events such as cardiac arrest, intensive care transfer, or sepsis. The applicability, development, clinical utility, and general perception of EWS in clinical practice vary widely. Here, we review the field as it has grown from early vital sign-based scoring systems to contemporary multidimensional algorithms and predictive technologies for clinical decompensation outside the ICU., Competing Interests: Disclosure K.E. Henry reports that under a license agreement between Bayesian Health and the Johns Hopkins University, she and Johns Hopkins University are entitled to revenue distributions. Additionally, the University owns equity in Bayesian Health. This arrangement has been reviewed and approved by the Johns Hopkins University in accordance with its conflict-of-interest policies. K.E. Henry also reports that she is currently an employee of Johnson & Johnson, but that this work was not related to or conducted as part of her employment and the views of this work do not necessarily reflect those of the company. Dr H.M. Giannini reports receiving income unrelated to this work from FVC Health, CalmWave., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Clinical risk factors alone fail to fully explain acute respiratory distress syndrome (ARDS) risk or ARDS death, suggesting that individual risk factors contribute. The goals of genomic ARDS studies include better mechanistic understanding, identifying dysregulated pathways that may be amenable to pharmacologic targeting, using genomic causal inference techniques to find measurable traits with meaning, and deconvoluting ARDS heterogeneity by proving reproducible subpopulations that may share a unique biology. This article discusses the latest advances in ARDS genomics, provides historical perspective, and highlights some of the ways that the coronavirus disease 2019 (COVID-19) pandemic is accelerating genomic ARDS research., (Copyright © 2021 Elsevier Inc. All rights reserved.)