Performances of the PAWS, PEWS and Bedside PEWS scores on the derivation sample on the first 24 hours, first 36 hours, first 48 hours and first 6 days
| Total scores analysed (complete and imputed with ‘default to normal’ method) | |||||
| Scores | AUC (95% CI) | Probability threshold (%)* | Specificity (%) | PPV (%) | NPV (%) |
| ≤24 hours (n=4693 observations; call to physician=494 (11%) observations) | |||||
| PAWS† | 0.87 (0.85 to 0.89) | 5.9 | 49 | 17 | 98 |
| PEWS‡ | 0.87 (0.86 to 0.89) | 6.0 | 48 | 17 | 98 |
| Bedside PEWS§ | 0.87 (0.85 to 0.89) | 5.2 | 48 | 16 | 98 |
| ≤36 hours (n=5892 observations; call to physician=559 (9%) observations) | |||||
| PAWS† | 0.90 (0.88 to 0.91) | 7.3 | 64 | 20 | 98 |
| PEWS‡ | 0.89 (0.88 to 0.91) | 6.7 | 55 | 17 | 98 |
| Bedside PEWS§ | 0.89 (0.87 to 0.91) | 6.2 | 58 | 17 | 98 |
| ≤48 hours (n=7196 observations; call to physician=629 (9%) observations) | |||||
| PAWS† | 0.91 (0.90 to 0.92) | 7.5 | 69 | 22 | 99 |
| PEWS‡ | 0.91 (0.89 to 0.92) | 7.4 | 71 | 23 | 99 |
| Bedside PEWS§ | 0.91 (0.89 to 0.92) | 6.7 | 70 | 21 | 99 |
| ≤6 day (n=10 152 observations; call to physician=749 (7%) observations) | |||||
| PAWS† | 0.91 (0.90 to 0.92) | 7.1 | 77 | 23 | 99 |
| PEWS‡ | 0.91 (0.90 to 0.92) | 7.1 | 76 | 23 | 99 |
| Bedside PEWS§ | 0.91 (0.90 to 0.92) | 6.1 | 75 | 21 | 99 |
If PAWS at admission=3, time=48 hours, PAWS (H48)=4.
Predictive equation for call to physician: Logit=−2.867+0.315×(4)−0.072×(3)−0.016×(48)=−2.591.
Probability of call to physician=1/(1+exp(−Logit)=7.0%.
This probability is <7.5% (probability threshold for PAWS from admission to 48 hours): so nurse must not call physician.
↵*Probability threshold maximising specificity for sensitivity fixed at 90%: probability computed from the general linear mixed model included the following effects: the score at time t, the score at admission and the time t.
†Predictive equation for call to physician: Logit=−2.867+0.315×(score at the time t)−0.072×(score at admission)−0.016×(time t); probability of call to physician=1/(1+exp(−Logit)).
‡Predictive equation for call to physician: Logit=−2.630+0.448×(score at the time t)−0.101×(score at admission)−0.017×(time t); probability of call to physician=1/(1+exp(−Logit)).
§Predictive equation for call to physician: Logit=−3.033+0.263×(score at the time t)−0.058×(score at admission)−0.015×(time t); probability of call to physician=1/(1+exp(−Logit)).
AUC, area under the receiver-operating curve; Bedside PEWS, Bedside Paediatric Early Warning System; NPV, negative predictive value; PAWS, Paediatric Advanced Warning Score; PEWS, Paediatric Early Warning Score; PPV, positive predictive value.