1. Development and validation of early warning score systems for COVID-19 patients
- Author
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Baptiste Vasey, Farah E. Shamout, Alexey Youssef, Rasheed El-Bouri, Drew A. Birrenkott, Andrew Soltan, Samaneh Kouchaki, Tingting Zhu, Thomas Taylor, David W Eyre, Jacob Armstrong, and David A. Clifton
- Subjects
medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,medicine.medical_treatment ,0206 medical engineering ,Vital signs ,Health Informatics ,02 engineering and technology ,Disease ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Health Information Management ,Medical technology ,Global health ,medicine ,Intubation ,R855-855.5 ,Warning system ,business.industry ,Early warning score ,020601 biomedical engineering ,Original Research Paper ,Emergency medicine ,Gradient boosting ,business ,Original Research Papers - Abstract
COVID‐19 is a major, urgent, and ongoing threat to global health. Globally more than 24 million have been infected and the disease has claimed more than a million lives as of November 2020. Predicting which patients will need respiratory support is important to guiding individual patient treatment and also to ensuring sufficient resources are available. The ability of six common Early Warning Scores (EWS) to identify respiratory deterioration defined as the need for advanced respiratory support (high‐flow nasal oxygen, continuous positive airways pressure, non‐invasive ventilation, intubation) within a prediction window of 24 h is evaluated. It is shown that these scores perform sub‐optimally at this specific task. Therefore, an alternative EWS based on the Gradient Boosting Trees (GBT) algorithm is developed that is able to predict deterioration within the next 24 h with high AUROC 94% and an accuracy, sensitivity, and specificity of 70%, 96%, 70%, respectively. The GBT model outperformed the best EWS (LDTEWS:NEWS), increasing the AUROC by 14%. Our GBT model makes the prediction based on the current and baseline measures of routinely available vital signs and blood tests.
- Published
- 2021