A multicentre validation study of the deep learning-based early warning score for predicting in-hospital cardiac arrest in patients admitted to general wards

The recently developed deep learning (DL)-based early warning score (DEWS) has shown potential in predicting deteriorating patients. We aimed to validate DEWS in multiple centres and compare the prediction, alarming and timeliness performance with the modified early warning score (MEWS) to identify...

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Bibliographic Details
Published in:Resuscitation 2021-06, Vol.163, p.78-85
Main Authors: Lee, Yeon Joo, Cho, Kyung-Jae, Kwon, Oyeon, Park, Hyunho, Lee, Yeha, Kwon, Joon-Myoung, Park, Jinsik, Kim, Jung Soo, Lee, Man-Jong, Kim, Ah Jin, Ko, Ryoung-Eun, Jeon, Kyeongman, Jo, You Hwan
Format: Article
Language:English
Subjects:
Artificial intelligence
Cardiac arrest
Deep learning
Early warning score
Prediction
Rapid response system
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Summary:The recently developed deep learning (DL)-based early warning score (DEWS) has shown potential in predicting deteriorating patients. We aimed to validate DEWS in multiple centres and compare the prediction, alarming and timeliness performance with the modified early warning score (MEWS) to identify patients at risk for in-hospital cardiac arrest (IHCA). This retrospective cohort study included adult patients admitted to the general wards of five hospitals during a 12-month period. The occurrence of IHCA within 24 h of vital sign observation was the outcome of interest. We assessed the discrimination using the area under the receiver operating characteristic curve (AUROC). The study population consists of 173,368 patients (224 IHCAs). The predictive performance of DEWS was superior to that of MEWS in both the internal (AUROC: 0.860 vs. 0.754, respectively) and external (AUROC: 0.905 vs. 0.785, respectively) validation cohorts. At the same specificity, DEWS had a higher sensitivity than MEWS, and at the same sensitivity, DEWS reduced the mean alarm count by nearly half of MEWS. Additionally, DEWS was able to predict more IHCA patients in the 24–0.5 h before the outcome, and DEWS was reasonably calibrated. Our study showed that DEWS was superior to MEWS in three key aspects (IHCA predictive, alarming, and timeliness performance). This study demonstrates the potential of DEWS as an effective, efficient screening tool in rapid response systems (RRSs) to identify high-risk patients.
ISSN:0300-9572
1873-1570
DOI:10.1016/j.resuscitation.2021.04.013