@article{ref1,
title="Validity of different pediatric early warning scores in the emergency department",
journal="Pediatrics",
year="2013",
author="Seiger, Nienke and Maconochie, Ian and Oostenbrink, Rianne and Moll, Henriette A.",
volume="132",
number="4",
pages="e841-50",
abstract="OBJECTIVE:Pediatric early warning scores (PEWS) are being advocated for use in the emergency department (ED). The goal of this study was to compare the validity of different PEWS in a pediatric ED.  METHODS:Ten different PEWS were evaluated in a large prospective cohort. We included children aged <16 years who had presented to the ED of a university hospital in The Netherlands (2009-2012). The validity of the PEWS for predicting ICU admission or hospitalization was expressed by the area under the receiver operating characteristic (ROC) curves.  RESULTS:These PEWS were validated in 17 943 children. Two percent of these children were admitted to the ICU, and 16% were hospitalized. The areas under the ROC curves for predicting ICU admission, ranging from 0.60 (95% confidence interval [CI]: 0.57-0.62) to 0.82 (95% CI: 0.79-0.85), were moderate to good. The area under the ROC curves for predicting hospitalization was poor to moderate (range: 0.56 [95% CI: 0.55-0.58] to 0.68 [95% CI: 0.66-0.69]). The sensitivity and specificity derived from the ROC curves ranged widely for both ICU admission (sensitivity: 61.3%-94.4%; specificity: 25.2%-86.7%) and hospital admission (sensitivity: 36.4%-85.7%; specificity: 27.1%-90.5%). None of the PEWS had a high sensitivity as well as a high specificity.  CONCLUSIONS:PEWS can be used to detect children presenting to the ED who are in need of an ICU admission. Scoring systems, wherein the parameters are summed to a numeric value, were better able to identify patients at risk than triggering systems, which need 1 positive parameter.<p /> <p>Language: en</p>",
language="en",
issn="0031-4005",
doi="10.1542/peds.2012-3594",
url="http://dx.doi.org/10.1542/peds.2012-3594"
}