CARS

• Research type

  Research Study

• Full title

  A novel Computer Aided Risk Score (CARS) for Acutely Ill Patients

• IRAS ID

  173753

• Contact name

  Mohammed A. Mohammed

• Contact email

  m.a.mohammed5@bradford.ac.uk

• Sponsor organisation

  University of Bradford

• Clinicaltrials.gov Identifier

  N/A, N/A

• Duration of Study in the UK

  1 years, 9 months, 30 days

• Research summary

  About 5% of deaths in English hospitals are preventable if care was improved and approximately 31% of those deaths were estimated to be from poor monitoring (Hogan et al 2012). This suggests that hospital teams are not always aware of the patient’s actual likelihood of deterioration and if such information was made available to them this could improve patient safety. Apart from Intensive Care Unit (ICU) teams, most other hospital teams do not have a score to indicate deterioration.
  National Early Warning Scores (NEWS) use measures such as temperature and heart rate to determine if a patient has a low, medium or high risk of deterioration (mostly used in ICU). We have shown that routine blood tests (collected as part of the process of care) combined with NEWS can provide a novel yet valid Computer-Aided Risk Score (CARS) for deterioration (including death) within 24 hours of admission. Therefore CARS could enhance and support near real-time clinical decision making and quality/safety of care, moving us away from just measuring past harm and learning from these to managing deterioration in real time and preventing death.

  AIM
  Our aim is to develop, implement and assess the impact of a novel real-time CARS into routine practice based on linked clinical data in two hospitals, over two years.

  OBJECTIVES
  Our objectives are to:-
  1. Develop and validate CARS in two hospitals
  2. Embed CARS into routine practice
  3. Determine the impact of CARS on clinical decision making and quality/safety of care
  4. Compare the care given in hospitals with and without CARS
  We will use mixed methods to measure the process and outcomes associated with the use of CARS. This will include focus groups with staff and members of the public (potential or previous not actual patients), post implementation observations of multidisciplinary team meetings and comparison of outcome measures in CARS and non-CARS hospitals.
  Hogan et al (2012) Preventable deaths due to problems in care in English acute hospitals: a retrospective case record review study BMJ Qual Saf doi:10.1136/bmjqs-2012-001159

  Lay Summary of Results:

  When people are admitted to hospital as an emergency, some patients become seriously unwell very quickly. Identifying these patients early can help healthcare staff provide timely treatment and improve outcomes.

  This project developed and evaluated the Computer-Aided Risk Score (CARS), a computer-based tool that helps hospitals identify patients at increased risk of serious illness or death. The system uses information routinely collected during hospital admission, including vital signs (such as blood pressure, pulse rate, breathing rate, temperature and oxygen levels) and standard blood test results. No additional tests or procedures were required.

  The study used routinely collected information from patients admitted to two NHS Trusts to assess how accurately CARS could identify patients at higher risk of poor outcomes.

  The results showed that CARS performed very well, accurately distinguishing between patients at higher and lower risk. This suggests that the system could help healthcare professionals recognise deteriorating patients earlier and support decisions about monitoring, treatment and care.

  The research programme generated more than ten peer-reviewed scientific publications and has increased understanding of how data-driven tools can support patient care in NHS hospitals. Further information about the project and its publications is available at carssresearch.org.
  Has the registry been updated to include summary results?: No
  If yes - please enter the URL to summary results:
  If no – why not?: N/A, as not registered
  Did you follow your dissemination plan submitted in the IRAS application form (Q A51)?: Yes
  If yes, describe or provide URLs to disseminated materials: https://gbr01.safelinks.protection.outlook.com/?url=https%3A%2F%2Ftrack.pstmrk.it%2F3ts%2Fcarssresearch.org%252Fresources%252F%2FNBTI%2F19XFAQ%2FAQ%2F037b0ecb-7129-4d1c-bbec-dd79b58944d8%2F1%2FAUmwqH-RqE&data=05%7C02%7Cleedswest.rec%40hra.nhs.uk%7Cf251d592070d4586375708dec303cb79%7C8e1f0acad87d4f20939e36243d574267%7C0%7C0%7C639162618238478739%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=OUj2GBK4VDxNLytgSmyByjy8jKkcoavmB7sCTRxd9oo%3D&reserved=0
  If pending, date when dissemination is expected:
  If no, explain why you didn't follow it:
  Have participants been informed of the results of the study?: Yes
  If yes, describe and/or provide URLs to materials shared and how they were shared: https://gbr01.safelinks.protection.outlook.com/?url=https%3A%2F%2Ftrack.pstmrk.it%2F3ts%2Fcarssresearch.org%252Fresources%252F%2FNBTI%2F19XFAQ%2FAQ%2F037b0ecb-7129-4d1c-bbec-dd79b58944d8%2F1%2FAUmwqH-RqE&data=05%7C02%7Cleedswest.rec%40hra.nhs.uk%7Cf251d592070d4586375708dec303cb79%7C8e1f0acad87d4f20939e36243d574267%7C0%7C0%7C639162618238514876%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=kmVGvTMZYl%2B8b324tMWzRc383qn7PeJNW0Br53uO7z0%3D&reserved=0
  If pending, date when feedback is expected:
  If no, explain why they haven't:
  Have you enabled sharing of study data with others?: No
  If yes, describe or provide URLs to how it has been shared:
  If no, explain why sharing hasn't been enabled: Our data sharing agreement with the two hospitals (York hospital & NLAG hospital) does not permit us to share this data with other parties. Nonetheless if anyone is interested in the data, then they should contact the R&D offices at each hospital in the first instance.
  Have you enabled sharing of tissue samples and associated data with others?: No
  If yes, describe or provide a URL:
  If no, explain why: N/A
  Captcha: 0cAFcWeA5oFZfmTJDUuDpaYyo4uAv2gHpgBatnyKfZ2e2wdgMWww_ZH0H3MQrjSPcuQVjdlswdhToxPpfooPwR9xnT8FCV-xiaBlVgxuBYnPwLw-Kj-f9lmdwwhWsLUsUTAAU6gE8ZHxF6sEInIiBVz7wx_XsjyXwpj0MDs___3coD35d0MRUbQVqNgTVGJ8wrsjwSe0qJa-spoP-V6osOdPMSUOcQd77r528kdnTbxVbVqtydKQdJWq9HiM5ntPJK92Uzq6EbD04GxxJTO3na2-sjbKdh5_8Bconm6F2ZA1gbp1d7MqKJBoo3V4UNlWjVlWFSn8cxM5ZF99hK5FDtokEpFXeArXTPS2xhQU6L85GNr2TkCKK2za7zBzQkbVbzwXXDonmsSlzmO5MXVA5xv9PdHM-5JqFOecXSxpPjmhI_gOjdNsMtx_wBrTCH8pc1-8e5PgxY7ylsGA8pmCz7hVNC-TUjtElGQnWqvjq6zYMM18tnSSOcUVvIA5YicIEJxkWjHONI7YTrBpa3KKlJNwfjL-NBBKDxgLj8qhq2mPFT-S38mnNH4kmYgfewfHk3ejcn_RSc4-pIRd5tptcl7705u4JVZxxbExFC_OZxk85SSQtlebrRSdPYqP0Z_lf-ujHfPsbrMwDJ18wXBPVFuR4zwzGSwn0mdPaP1M4xt7-Jg_zspnVyGCG2H4KEpsM2y0y741KWWKcMziojI3Xr8LHDPC2O11CH-enPw7B4chCc6qowxEQtLp7ADYPKQ_1E-oxuEDd0hOBOpSAJeSuvh_famPewfEtppJUqu-Hn7aReiCbR3vNzfDFtjFLxJj09_OKmEkHCyezIPTp0xNqvh75rLGLMN8WHcrMB-nGXWzYiPbIMke9AX6Ts-23ZWbyqoxbI2cbY7S0-TZ9XhNUVeoY2TrY-qbn4-b_R8-PRq5tA2SbPVSQ-R0fYxCKYajEDoSne8IlkFShfEPX4k7H2pRS_6Y42G000Po8mvy9iUORYqZ0teDC-mMP9AFCkd-vYz2Si8aEp8MUDEKNnaMfQW1xe6SvHdiTrIxFT1y92guvUMC2QRrr1N4kwpOF9I1BUagZrhVOmGmBR

• REC name

  Yorkshire & The Humber - Leeds West Research Ethics Committee

• REC reference

  15/YH/0348

• Date of REC Opinion

  17 Sep 2015

• REC opinion

  Further Information Favourable Opinion