Why current clinical scoring systems don’t work when assessing acutely ill children in general practice

Today, we’re speaking to Dr Amy Clark and Dr Kathryn Hughes. Amy is a resident doctor in North West Anglia Foundation Trust, and Kathryn who is a GP and a Senior Clinical Lecturer based at PRIME Centre Wales within Cardiff University. 

Title of paper: Assessing acutely ill children in general practice using the National PEWS and LqSOFA clinical scores: a retrospective cohort study

Available at: https://doi.org/10.3399/BJGP.2023.0638

The validity of the current NICE-recommended scoring system for identifying seriously ill children in general practice, the Traffic Light system, was recently investigated and shown to perform poorly. A new National PEWS (Paediatric Early Warning Score) has just been introduced in hospital settings with hopes for subsequent implementation in general practice, to improve the identification of seriously unwell children. To the authors’ knowledge, the score has not previously been validated in general practice. This study found that the National PEWS would not accurately identify children requiring hospital admission within two days of presenting to general practice with an acute illness and therefore should not be recommended for this purpose without adjustment. Another score, the Liverpool quick Sequential Organ Assessment (Lq-SOFA), was also investigated and found to perform poorly in general practice.