Comparative performance
| AUROC (95% CI) | z-Score | p Value | |
|---|---|---|---|
| Scoring systems | |||
| Cardiff and Vale PEWS | 0.89 (0.86 to 0.91) | N/A | N/A |
| Bedside PEWS | 0.88 (0.85 to 0.91) | 0.72 | 0.47 |
| Modified PEWS III | 0.87 (0.85 to 0.90) | 1.58 | 0.11 |
| Children's Early Warning Tool | 0.85 (0.82 to 0.88) | 3.21 | 0.001 |
| Modified PEWS II | 0.85 (0.82 to 0.88) | 2.87 | 0.004 |
| PEWS I | 0.83 (0.80 to 0.86) | 4.06 | <0.001 |
| NHSI PEWS | 0.82 (0.79 to 0.86) | 4.52 | <0.001 |
| PEWS system score | 0.82 (0.78 to 0.85) | 4.42 | <0.001 |
| PEWS II | 0.79 (0.75 to 0.82) | 6.00 | <0.001 |
| CEWS | 0.79 (0.75 to 0.82) | 7.12 | <0.001 |
| ITAT score | 0.77 (0.74 to 0.81) | 7.12 | <0.001 |
| Modified PEWS I | 0.74 (0.70 to 0.78) | 8.06 | <0.001 |
| Trigger systems | |||
| THSC MET calling criteria | 0.73 (0.69 to 0.77) | 9.31 | <0.001 |
| MET activation criteria I | 0.71 (0.70 to 0.75) | 10.70 | <0.001 |
| MET activation criteria II | 0.71 (0.70 to 0.75) | 10.70 | <0.001 |
| PMET triggers I | 0.71 (0.67–0.75) | 10.82 | <0.001 |
| Modified Bristol PEWS | 0.62 (0.58 to 0.67) | 16.01 | <0.001 |
| Bristol PEWS | 0.62 (0.58 to 0.67) | 16.01 | <0.001 |
Performance was assessed by calculation of the AUROC. Systems were then ranked, and performance was compared with the highest ranked PEWS (Cardiff and Vale PEWS) using Delong's test for correlated curves. z-scores represent comparison of mean values. Significance testing was adjusted for the multiple comparisons of AUROC with Bonferroni's correction, meaning values of p<0.0025 were considered significant.
AUROC, area under the receiver operator characteristic curve; CEWS, Children's Early Warning Score; ITAT, inpatient triage, assessment and treatment score; MET, Medical Emergency Team; NHSI, NHS Institute; PEWS, paediatric early warning system; PMET, Paediatric Medical Emergency Team; THSC, Toronto Hospital for Sick Children.