British researchers design death risk tool for COVID-19 patients

webfact · September 9, 2020

British researchers design death risk tool for COVID-19 patients

By Kate Kelland

FILE PHOTO: Signs on a door in the Emergency Department are seen at Wexham Park Hospital near Slough, Britain, May 22, 2020. Steve Parsons/Pool via REUTERS/File Photo

LONDON (Reuters) - British scientists have developed a four-level scoring model for predicting the death risk of patients hospitalised with COVID-19, saying it should help doctors quickly decide on the best care for each patient.

The tool, detailed in research published in the BMJ medical journal on Wednesday, helps doctors put patients into one of four COVID-19 risk groups - from low, to intermediate, high, or very high risk of death.

With hospitals around the world facing waves of patients with COVID-19, the disease caused by the novel coronavirus, doctors have said they need quicker and more accurate risk prediction tools to swiftly identify those patients at highest risk of dying and help get them targeted treatment.

The new model - called the 4C (Coronavirus Clinical Characterisation Consortium) Mortality Score - uses data such as age, sex, underlying conditions, breathing and blood oxygen levels. Study results showed it was able to more accurately predict risk than 15 comparable models, the researchers said, and it was also more useful in clinical decision-making.

"This will prove important in helping guide doctors to optimally care for the sickest of patients," said Ewen Harrison, a professor of surgery and data science at Edinburgh University who co-led the research and presented it at a briefing.

Using the various data input, the risk calculator gives scores ranging from 0 to 21 points, he said. Patients with a score of 15 or more had a 62% mortality risk compared with 1% for those scoring 3 or lower.

The researchers said patients with a low 4C Mortality Score might not need to be admitted to hospital, while those in medium and higher risk groups could be expedited for more aggressive treatment, including steroid drugs and being admitted to critical care units if necessary.

(Reporting by Kate Kelland; Editing by Christopher Cushing)

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2long · September 10, 2020

Well, here's another opportunity for certain groups of people (race, religion, gender choice) to jump on a band wagon and either claim discrimination or get preferential treatment.

My guess is that many lower/working class indigenous Britons whose parents may have fought in WWII may miss out, when in truth they should be at the front of any queue.

edwinchester · September 10, 2020

1 hour ago, 2long said:

Well, here's another opportunity for certain groups of people (race, religion, gender choice) to jump on a band wagon and either claim discrimination or get preferential treatment.

My guess is that many lower/working class indigenous Britons whose parents may have fought in WWII may miss out, when in truth they should be at the front of any queue.

Several of my own family work in the NHS, on the frontline, and treatment is given according to needs nothing else.

Dumbastheycome · September 10, 2020

6 minutes ago, edwinchester said:

Several of my own family work in the NHS, on the frontline, and treatment is given according to needs nothing else.

But it does read like a system that could contain potential for "biased" selective evaluation prior to treatment according to needs !

OJAS · September 10, 2020

29 minutes ago, Dumbastheycome said:

But it does read like a system that could contain potential for "biased" selective evaluation prior to treatment according to needs !

Not to mention the length of time which the evaluation process would probably take. I can just imagine a scenario where someone in a critical state (not on account of COVID-19, incidentally) is rushed into A&E only to be informed that there is nothing which could be done by way of treatment until the COVID-19 risk had been fully and thoroughly evaluated in their case. By which time it could well be too late!

edwinchester · September 10, 2020

34 minutes ago, Dumbastheycome said:

But it does read like a system that could contain potential for "biased" selective evaluation prior to treatment according to needs !

I have strong doubt that would ever happen as the patient would already have presented and indicators such as breathing state and blood levels would be a high priority for treatment.

edwinchester · September 10, 2020

5 minutes ago, OJAS said:

Not to mention the length of time which the evaluation process would probably take. I can just imagine a scenario where someone in a critical state (not on account of COVID-19, incidentally) is rushed into A&E only to be informed that there is nothing which could be done by way of treatment until the COVID-19 risk had been fully and thoroughly evaluated in their case. By which time it could well be too late!

If somebody is in a critical state treatment begins immediately.

Chomper Higgot · September 10, 2020

4 hours ago, 2long said:

Well, here's another opportunity for certain groups of people (race, religion, gender choice) to jump on a band wagon and either claim discrimination or get preferential treatment.

My guess is that many lower/working class indigenous Britons whose parents may have fought in WWII may miss out, when in truth they should be at the front of any queue.

I suspect the person at the front of the queue will be s/he in most critical need of care.

Perhaps the NHS could develop a ‘Analysis Tool’ to determine who needs help with their ‘poor me I’m a victim’ complex.

Chomper Higgot · September 10, 2020

2 hours ago, Dumbastheycome said:

But it does read like a system that could contain potential for "biased" selective evaluation prior to treatment according to needs !

As explained the ‘Analysis Tool’ relies on clinical data.

Perhaps you can explain how other ‘non-clinical’ factors might be introduced to create the ‘potential ‘ bias you claim.

evadgib · September 10, 2020

I remain of the opinion that this was never more than seasonal flu & that the entire shooting match has been a monumental over reaction/hoax.

soalbundy · September 10, 2020

5 hours ago, Dumbastheycome said:

But it does read like a system that could contain potential for "biased" selective evaluation prior to treatment according to needs !

You mean like, high risk you get a hammock in the car park or go private.

Chomper Higgot · September 10, 2020

2 hours ago, evadgib said:

I remain of the opinion that this was never more than seasonal flu & that the entire shooting match has been a monumental over reaction/hoax.

Well of course you do.

Don’t let medical and scientific evidence get in the way of your need to stick to a unfounded belief.

Scot123 · September 10, 2020

Now this is a trend that worries me about the UK and that is there seems to be a great effort to cull the old and sick. I do speak from some experience as my mother is terminal 80+ with the big C (my mother is living a normal life at the moment). She fell and broke her hip and wrist the doctor tried his hardest to get big sis to sign a do not resuscitate even saying/lying that my mum had already agreed. What a mess, they never even set her wrist right. It is a very slippery slope prioritizing treatment other than the 4 B's. And what Como did to old people in America was mass murder and akin to giving native Indians small pox coverd blankets.

Srikcir · September 10, 2020

Might add a fifth: is there a next of kin?

None? Alrighty then, a bed in the hallway and space in the freezer.

evadgib · September 10, 2020

23 minutes ago, Chomper Higgot said:

Well of course you do.

Don’t let medical and scientific evidence get in the way of your need to stick to a unfounded belief.

It seems i'm not alone...

Dumbastheycome · September 10, 2020

5 hours ago, Chomper Higgot said:

As explained the ‘Analysis Tool’ relies on clinical data.

Perhaps you can explain how other ‘non-clinical’ factors might be introduced to create the ‘potential ‘ bias you claim.

Unlike an impartial machine "Tool" initial human evaluation in assessment could be biased for many reasons.

However my comment was based on the wording impact of "Death Risk Tool" which although may be intended to eliminate aspects of human error summons up something other IMO.

Meat Inspector's check sheet" ?