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Lisez la limite, pas la promesse. La validation locale compte plus que la brochure.
The Epic Sepsis Model is a proprietary score switched on in a large number of U.S. hospitals. Researchers at Michigan Medicine compared it with sepsis in their own hospitalizations, instead of relying on the vendor performance sheet. The paper is included here because a familiar model can still fail local validation. Widespread deployment is not the same thing as demonstrated usefulness.
Adult hospitalizations at Michigan Medicine, with the score recalculated through the stay and compared with sepsis defined from surveillance criteria and the record.
Across 38,455 hospitalizations, the hospitalization-level AUC was 0.63 (95% CI 0.62–0.64), below the discrimination the developer had reported. At a score of 6 or higher the model alerted on 18% of hospitalizations, did not identify 67% of sepsis cases, and found only 7% of sepsis patients who had not already received timely antibiotics.
Wong et al., JAMA Internal Medicine · 21 juin 2021 · Année 2021
Ajouté à l index 2 juin 2026
Ouvrir la sourceFiche pour l éducation et la veille. Pas un avis médical ni un soutien.
Aide à la décision clinique
PubliéThe Targeted Real-time Early Warning System (TREWS) watches the electronic record and asks a clinician to confirm or dismiss a possible sepsis alert. It was studied prospectively across five hospitals, not as a silent background score. The published association depends on a person acting on the alert within a few hours. It does not diagnose sepsis by itself.
TREWS · Bayesian Health
Réanimation
IllustratifThis is an illustrative composite, not a trial report. Each morning the rapid-response nurse opens a list that combines a NEWS2-style vital-sign score with a model score from the record. The huddle decides who needs a bedside review. The score does not page a code team, order labs, or write a note. Hospitals using a vendor deterioration index should repeat a local check before trusting the threshold, as the sepsis literature already shows.
EHR deterioration score · NEWS2
Surveillance à distance
IllustratifThis is an illustrative composite, not a trial report. Daily weight, blood pressure, and a short symptom check land in a pool. A simple model ranks who should be called today when the heart-failure nurse starts the shift. The nurse places the call and decides on a diuretic plan with the covering clinician. The scenario deliberately stops before any claim that admissions fell. Device trials of hemodynamic monitors are a different evidence base and are not borrowed here.
Home weight and blood pressure · Clinic message pool