Rocket scientists need not apply

摘要

We thank Professor Smith and colleaguesfor their interest in our paper. We note withinterest that their unpublished work hasconfirmed our hypothesis that the sensitivityand specificity of existing earlywarning systems (EWS) are reducedamongst patients with underlying respiratorydisease compared with unselectedmedical patients. We agree that furtherrefinements to our proposed modifiedscoring system that allocates EWS pointsbased on oxygen saturation will be required.We are currently testing a few differentmodels of EWS oxygen scoring for respiratorypatients and general medical patients,and we look forward to working with theRoyal College of Physicians team and withProfessor Smith and colleagues on developingevidence-based EWS models thatwill enhance the care and safety of patientswith chronic respiratory disease whorequire hospital admission.