Measurements of clinical data were made at 2961 individual times. The most frequently measured items were heart rate, respiratory rate respiratory effort, oxygen therapy and level of consciousness (Table (Table22).Table 1Candidate items evaluated for Bedside PEWS scoreTable 2Frequency of measurement and item sub-scores of candidate Ceritinib items for Bedside Paediatric Early Warning System scoreScore developmentEleven candidate items were evaluated; heart rate, systolic blood pressure, capillary refill time (CRT), pulses, bolus fluid administration, respiratory rate, respiratory effort, trans-cutaneous oxygen saturation, oxygen therapy, level of consciousness and temperature. Given the infrequent scoring with the Glasgow Coma Scale we found in our previous work, the Bromage Sedation Scale and a description of infant behaviour was used to assess levels of consciousness [12].

Expert-derived categories were associated with sub-scores of 0, 1, 2 or 4 (Table (Table1)1) for each item.Item selectionSub-scores from 10 of 11 items were significantly different (all P < 0.0001) with differences between case and control patients ranging from 0.42 to 2.0 points (Table (Table2).2). Sub-scores were not significantly different between case and control patients for bolus fluid administration (P = 0.07), and this item was excluded from further evaluation.The AUCROC for the remaining items ranged from 0.54 to 0.83 (Table (Table2).2). Heart rate, respiratory rate, respiratory effort and oxygen therapy had AUCROC of more than 0.75 and were included in the score.

Level of consciousness and pulses did not adequately discriminate and were excluded from further evaluation (AUCROC �� 0.65).There were four remaining candidate items with intermediate AUCROC of more than 0.65 and 0.75 or less. These items were measured with differing frequencies and had differences between maximum sub-scores for case and control patients; systolic blood pressure (33%, 0.74), saturation (61%, 0.73), CRT (25%, 1.4), and temperature (25%, 0.45), suggesting that CRT had the greatest potential impact on the total score, and temperature the least.Four candidate scores were then evaluated. The simplest was the four core items. CRT was added to the core items, followed by the addition of saturation and then systolic blood pressure. Temperature was added as the last item.

Performance of candidate scoresAll candidate scores Batimastat could discriminate between case and control patients. Scores containing more items had greater maximum and mean scores, and greater differences between groups (Table (Table3).3). The difference between the mean maximum scores of case and control patients ranged from 5.8 in the core item only score, to 6.9 in the score with all eight items. The inclusion of temperature did not greatly alter the AUCROC, maximum or mean scores of case and control patients, and it was excluded.