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Table 2 Performance of APPROVE in retrospective and prospective validation cohorts to predict for qualifying event at any time after score calculation

From: Multicenter derivation and validation of an early warning score for acute respiratory failure or death in the hospital

   APPROVE MEWS NEWS
Cutoff > 0.15 Cutoff > 0.20 Cutoff > 0.25 Cutoff > 4 Cutoff > 5 Cutoff > 6 Cutoff > 4 Cutoff > 5 Cutoff > 6
2013a Sensitivity
(95% CI)
0.75 (0.72–0.77) 0.69 (0.66–0.71) 0.63 (0.60–0.66) 0.16 (0.13–0.18) 0.08 (0.07–0.11) 0.04 (0.03–0.06) 0.28 (0.25–0.31) 0.22 (0.19–0.25) 0.16 (0.13–0.18)
Specificity
(95% CI)
0.83 (0.83–0.83) 0.88 (0.88–0.89) 0.92 (0.92–0.92) 0.98 (0.98–0.98) 0.99 (0.99–0.99) 0.99 (0.99–0.99) 0.94 (0.94–0.94) 0.97 (0.97–0.97) 0.99 (0.98–0.99)
Positive predictive value
(95% CI)
0.13 (0.12–0.14) 0.17 (0.16–0.18) 0.21 (0.19–0.22) 0.19 (0.16–0.22) 0.37 (0.30–0.44) 0.54 (0.42–0.66) 0.11 (0.10–0.13) 0.16 (0.14–0.18) 0.22 (0.19–0.25)
Negative predictive value
(95% CI)
0.99 (0.99–0.99) 0.99 (0.99–0.99) 0.99 (0.99–0.99) 0.98 (0.98–0.98) 0.98 (0.97–0.98) 0.98 (0.97–0.98) 0.98 (0.98–0.98) 0.98 (0.98–0.98) 0.98 (0.98–0.98)
False positive rate (95% CI) 0.17 (0.17–0.17) 0.12 (0.11–0.12) 0.08 (0.08–0.08) 0.02 (0.02–0.02) 0.01 (0.01–0.01) 0.01 (0.01–0.01) 0.06 (0.06–0.06) 0.03 (0.03–0.03) 0.01 (0.01-0.01)
2017b Sensitivity
(95% CI)
0.89 (0.74–0.97) 0.69 (0.52–0.84) 0.64 (0.46–0.79) 0.67 (0.49–0.81) 0.39 (0.23–0.57) 0.19 (0.08–0.36) 0.67 (0.49–0.81) 0.47 (0.30–0.65) 0.39 (0.23–0.57)
Specificity
(95% CI)
0.85 (0.83–0.86) 0.91 (0.90–0.92) 0.95 (0.94–0.96) 0.86 (0.85–0.88) 0.96 (0.95–0.97) 0.99 (0.99–0.99) 0.75 (0.73–0.76) 0.86 (0.85–0.88) 0.93 (0.92–0.94)
Positive predictive value
(95% CI)
0.09 (0.06–0.12) 0.11 (0.07–0.16) 0.16 (0.11–0.23) 0.07 (0.05–0.11) 0.15 (0.08–0.23) 0.29 (0.13–0.51) 0.04 (0.03–0.06) 0.05 (0.03–0.08) 0.08 (0.05–0.14)
Negative predictive value
(95% CI)
0.99 (0.99–0.99) 0.99 (0.99–0.99) 0.99 (0.99–0.99) 0.99 (0.99–0.99) 0.99 (0.98–0.99) 0.99 (0.98–0.99) 0.99 (0.99–0.99) 0.99 (0.98–0.99) 0.99 (0.98–0.99)
False positive rate (95% CI) 0.15 (0.13–0.16) 0.09 (0.08–0.10) 0.05 (0.04–0.06) 0.14 (0.12–0.15) 0.04 (0.03–0.04) 0.01 (0.00–0.01) 0.25 (0.23–0.27) 0.14 (0.12–0.15) 0.07 (0.06–0.08)
  1. Qualifying event defined as death or intubation that leads to at least 48 h of mechanical ventilation
  2. APPROVE Accurate Prediction of Prolonged Ventilation, CI confidence interval, MEWS Modified Early Warning Score, NEWS National Early Warning Score ale
  3. aAPPROVE calculated every time there are new data to predict for qualifying event any time in hospital after score calculation
  4. bAPPROVE calculated every 4 h after hospital admission to predict for qualifying event any time in hospital after score calculation