Comparison of NEWS2 and Machine Learning for Early Sepsis Warning

Condition(s) studied

Investigational drug(s) / intervention(s)

Observational Study - No Intervention: Observational Study - No Intervention

Study summary

This prospective observational study aims to objectively measure the lead-time (the time from the first KDS alert to sepsis diagnosis) of the NEWS2-based clinical decision support system (KDS) and compare its early warning performance with a machine learning model trained on 2000 patients and externally validated. The study seeks to answer the following main questions:

How early does the NEWS2-based KDS provide an alert before sepsis diagnosis?

Does a machine learning model, developed using logistic regression and externally validated in a prospective cohort, offer superior specificity and comparable sensitivity to KDS?

Participants who are already receiving routine clinical care at Kocaeli City Hospital will have their vital signs and laboratory data monitored as part of standard practice. NEWS2 scores will be calculated automatically and the time of the first alert (T0) will be recorded. Sepsis diagnosis will be confirmed by an increase in SOFA score ≥ 2 (T1), evaluated by two independent and blinded physicians. Lead-time will be calculated as the difference between T1 (hours×60) and T0 (minutes). The machine learning model will be tested prospectively on this cohort, and its performance will be compared with KDS using sensitivity, specificity, F1 score, ROC-AUC, and accuracy.

Eligibility

Primary outcome measure(s)

• Lead-Time Calculated from NEWS2 KDS Alert and SOFA Score Change — From hospital admission to sepsis diagnosis, death, or discharge, whichever occurs first, assessed up to 14 days
  Lead-time is defined as the time from the first KDS alert (NEWS2 ≥ 5) to the diagnosis of sepsis, confirmed by an increase in SOFA score ≥ 2 points. It is calculated using the formula: Lead-Time (minutes) = \[T1 (hours × 60)\] - T0 (minutes), where T0 is the time of the first NEWS2 measurement and T1 is the time of first SOFA increase ≥ 2.

Trial sites (1)

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