Table 3

Comparative performance

AUROC (95% CI)z-Scorep Value
Scoring systems
 Cardiff and Vale PEWS0.89 (0.86 to 0.91)N/AN/A
 Bedside PEWS0.88 (0.85 to 0.91)0.720.47
 Modified PEWS III0.87 (0.85 to 0.90)1.580.11
 Children's Early Warning Tool0.85 (0.82 to 0.88)3.210.001
 Modified PEWS II0.85 (0.82 to 0.88)2.870.004
 PEWS I0.83 (0.80 to 0.86)4.06<0.001
 NHSI PEWS0.82 (0.79 to 0.86)4.52<0.001
 PEWS system score0.82 (0.78 to 0.85)4.42<0.001
 PEWS II0.79 (0.75 to 0.82)6.00<0.001
 CEWS0.79 (0.75 to 0.82)7.12<0.001
 ITAT score0.77 (0.74 to 0.81)7.12<0.001
 Modified PEWS I0.74 (0.70 to 0.78)8.06<0.001
Trigger systems
 THSC MET calling criteria0.73 (0.69 to 0.77)9.31<0.001
 MET activation criteria I0.71 (0.70 to 0.75)10.70<0.001
 MET activation criteria II0.71 (0.70 to 0.75)10.70<0.001
 PMET triggers I0.71 (0.67–0.75)10.82<0.001
 Modified Bristol PEWS0.62 (0.58 to 0.67)16.01<0.001
 Bristol PEWS0.62 (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.