It is based on a logistic regression model designed to predict in-hospital patient mortality within 24 hours of a set of vital sign observations. The National Early Warning Score (NEWS) was launched by the Royal College of Physicians (RCP) in 2012 to improve the identification, monitoring and management of unwell patients in hospital. However, a face-to-face consultation should not be arranged solely to calculate a NEWS2 score” (paragraph 3.7). The guideline states that “Use of the NEWS2 tool in the community for predicting the risk of clinical deterioration may be useful. NICE guidance for the management of COVID-19 pneumonia in a primary care setting is much more circumspect, reflecting the lack of direct evidence of the value of this score in the primary care context. NEWS2 is recommended by the National Institute for Health and Care Excellence (NICE) in its guidelines for the management of COVID-19 patients in critical care. The former are primarily concerned with the methods (was the study done right? is it biased? etc.) the latter are concerned with meaning-making from complex bodies of evidence. Rather than present an exhaustive analysis of every published paper on NEWS, we have chosen to review a selected sample of studies and scholarly commentaries using a combination of conventional critical appraisal techniques and narrative (hermeneutic) methodology. This review attempts to make sense of a complex and contested literature. It should also be remembered that not every sick patient has COVID-19. If used at all, this score should be used alongside a wider clinical assessment of the patient and in the context of changes over time.įurther research is needed on the use of NEWS/NEWS2 in primary care, and on the use of prognostic scores more generally in the context of COVID-19.
It does not include age or comorbidities, which are known to be strong independent predictors of survival in COVID-19.Įnthusiasm for NEWS2 in the primary care management of COVID-19 may be premature. NEWS2 includes blood pressure and oxygen saturation measurements that are difficult or impossible to take remotely. There is no research on the value of these tools for COVID-19 outside hospital. NEWS and its updated version, NEWS2, are early warning scores which were originally developed for monitoring hospital in-patients over time using repeated measurements. West of England Academic Health Science Network On behalf of the Oxford COVID-19 Evidence Service TeamĬentre for Evidence-Based Medicine, Nuffield Department of Primary Care Health SciencesĬorrespondence to contributors (topic experts): NEWS (or NEWS2) score when assessing possible COVID-19 patients in primary care?
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