SynthesisThorax2025
Oxygen therapy in early warning scores: a systematic review and meta-analysis.
Synthesis in Thorax, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
- Validation and performance of a geriatric early warning score (GEWS) versus the national early warning score (NEWS) in predicting clinical deterioration in frail older patients.European geriatric medicine · 2026Observational
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEarly warning systems (EWS) used across the world typically assign a fixed number of points to patients receiving supplemental oxygen, regardless of amount. This ordinal binary approach may fail to recognise deteriorating patients who have an increasing oxygen requirement with otherwise stable observations. It is unclear whether weighting oxygen beyond binary scoring improves recognition of deterioration.
aimsWe aimed to describe all general adult EWS that grade oxygen beyond binary scoring (part 1). Where reported, we summarised the performance of graded oxygen EWS in comparison to binary scoring (part 2).
methodsWe systematically reviewed the literature, searching Embase, MEDLINE, CINAHL, Cochrane Central and Web of Science. We included studies of vital-sign-only EWS, for adult inpatients, which included grades of oxygen therapy above binary weighting ('graded oxygen weighting'). We summarised methods of including graded oxygen therapy. We performed a random-effects meta-analysis of the effects of graded oxygen weighting inclusion in comparison to binary weighting. Risk of bias was assessed using the Prediction model Risk Of Bias ASsessment Tool.
results15 studies reported the development of 16 EWS with graded oxygen weighting, classified by flow rate, delivery device and/or fraction of inspired oxygen. Four studies compared graded oxygen EWS to binary oxygen EWS. Meta-analysis showed a significant improvement in the performance of graded oxygen EWS over binary oxygen EWS (logit(AUROC)=0.19; 95% CI 0.094 to 0.285; p=0.002). 15/16 models were at high risk of bias.
conclusions16 EWS with graded oxygen weighting were identified. Graded oxygen models had improved recognition of deterioration. Future work should explore the optimal method of oxygen classification and how this could be integrated into future EWS. PROSPERO REGISTRATION NUMBER: CRD42024443362.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.