{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T12:53:31Z","timestamp":1789044811551,"version":"build-2803163510"},"reference-count":24,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,6,15]],"date-time":"2020-06-15T00:00:00Z","timestamp":1592179200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro Eating Disorders Rev"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We aimed to evaluate the validity of a MARSIPAN\u2010guidance\u2010adapted Early Warning System (MARSI MEWS) and compare it to the National Early Warning Score (NEWS) and an adapted version of the Physical Risk in Eating Disorders Index (PREDIX), to ascertain whether current practice is comparable to best\u2010practice standards.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We collated 3,937 observations from 36 inpatients from Addenbrookes Hospital over 2017\u20132018 and used three independent raters to create a \u201cgold standard\u201d of deteriorating cases. We ascertained performance metrics (Receiver Operating Characteristic Area Under the curve) for MARSI MEWS, NEWS and PREDIX; we also tested the proof of concept of a machine\u2010learning\u2010based early\u2010warning\u2010system (ML\u2010EWS) using cross\u2010validation and out\u2010of\u2010sample prediction of cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The MARSI MEWS system showed higher ROC AUC (0.916) compared to NEWS (0.828) or PREDIX (0.865). ML\u2010EWS (random forest) performed well at independent samples analysis (0.980) and multilevel analysis (0.922).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>MARSI MEWS seems most suitable for identifying critically deteriorating cases in anorexia nervosa inpatient population. We did not examine community practice in which the PREDIX arguably remains the best to ascertain deteriorating cases. Our results also provide a first proof of concept for the development of artificial\u2010intelligence\u2010based early warning systems in anorexia nervosa. Implications for inpatient clinical practice in eating disorders are discussed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/erv.2753","type":"journal-article","created":{"date-parts":[[2020,6,16]],"date-time":"2020-06-16T01:18:28Z","timestamp":1592270308000},"page":"551-558","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Early warning systems in inpatient anorexia nervosa: A validation of the\n                    <scp>MARSIPAN<\/scp>\n                    \u2010based modified early warning system"],"prefix":"10.1002","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1537-5425","authenticated-orcid":false,"given":"Konstantinos","family":"Ioannidis","sequence":"first","affiliation":[{"name":"Cambridge and Peterborough NHS Foundation Trust  Cambridge UK"},{"name":"Department of Psychiatry University of Cambridge  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaco","family":"Serfontein","sequence":"additional","affiliation":[{"name":"Cambridge and Peterborough NHS Foundation Trust  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Deakin","sequence":"additional","affiliation":[{"name":"Cambridge and Peterborough NHS Foundation Trust  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie","family":"Bruneau","sequence":"additional","affiliation":[{"name":"Cambridge and Peterborough NHS Foundation Trust  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anya","family":"Ciobanca","sequence":"additional","affiliation":[{"name":"Cambridge and Peterborough NHS Foundation Trust  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leah","family":"Holt","sequence":"additional","affiliation":[{"name":"Cambridge and Peterborough NHS Foundation Trust  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Snelson","sequence":"additional","affiliation":[{"name":"Cambridge and Peterborough NHS Foundation Trust  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Stochl","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Cambridge  Cambridge UK"},{"name":"Department of Kinanthropology Charles University in Prague  Star\u00e9 M\u011bsto Czechia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,6,15]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/archgenpsychiatry.2011.74"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-0-387-45528-0"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1214\/ss\/1009213726"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.71.3.287"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-007-0532-3"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-019268"},{"key":"e_1_2_8_8_1","volume-title":"Springer series in statistics: The elements of statistical learning data mining, inference, and prediction","author":"Hastie T.","year":"2008"},{"key":"e_1_2_8_9_1","doi-asserted-by":"crossref","unstructured":"Ioannidis K. Lewis G. Waterston J. Connolly C. Clay F. Copping C. \u2026Serfontein J.(2019 June 6). MARSIPAN\u2010based Early Warning Signs System: A full Audit cycle in the Inpatient Eating Disorders Ward.https:\/\/doi.org\/10.31219\/osf.io\/fgj78","DOI":"10.31219\/osf.io\/fgj78"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.2147\/VHRM.S28652"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.7861\/clinmedicine.12-6-501"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1192\/apt.bp.111.009779"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.118.008678"},{"key":"e_1_2_8_14_1","unstructured":"MARSIPAN The Royal Colleges of Psychiatrists Physicians and Pathologists (2014).MARSIPAN: Management of Really Sick Patients with Anorexia Nervosa 2nd edition CR189. Retrieved fromhttps:\/\/www.rcpsych.ac.uk\/docs\/default-source\/improving-care\/better-mh-policy\/college-reports\/college-report-cr189.pdf?sfvrsn=6c2e7ada_2"},{"key":"e_1_2_8_15_1","unstructured":"McCluskey S. &Robinson P.(2015).The MARSI MEWS Dr Sara McCluskey and Dr Paul Robinson. Evolution of the MARSI MEWS results of audit validation. Retrieved from Priory website:https:\/\/docplayer.net\/53475835-The-marsi-mews-dr-sara-mccluskey-and-dr-paul-robinson-evolution-of-the-marsi-mews-results-of-audit-validation.html"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2004-0540"},{"key":"e_1_2_8_17_1","first-page":"100","article-title":"An early warning scoring system for detecting developing critical illness","volume":"8","author":"Morgan R.","year":"1997","journal-title":"Clinical Intensive Care"},{"key":"e_1_2_8_18_1","unstructured":"National Institute for Health and Care Excellence. (2019).Acutely ill patients in hospital overview \u2010 NICE pathways. Retrieved fromhttps:\/\/pathways.nice.org.uk\/pathways\/acutely-ill-patients-in-hospital#path=view%3A\/pathways\/acutely-ill-patients-in-hospital\/acutely-ill-patients-in-hospital-overview.xml&content=view-index"},{"key":"e_1_2_8_19_1","unstructured":"National Institute of Health and Care Excellence. (2007).Acutely ill adults in hospital: Recognising and responding to deterioration|Guidance and guidelines|NICE. Retrieved fromhttps:\/\/www.nice.org.uk\/guidance\/cg50"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1054-139X(02)00533-5"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201403-102OC"},{"key":"e_1_2_8_22_1","unstructured":"Treasure J.(2009).A guide to the medical risk assessment for eating disorders. Retrieved from King's College London and South London and Maudsley NHS Foundation Trust website:https:\/\/www.kcl.ac.uk\/ioppn\/depts\/pm\/research\/eatingdisorders\/resources\/GUIDETOMEDICALRISKASSESSMENT.pdf"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0217864"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2015-008699"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2014.04.009"}],"container-title":["European Eating Disorders Review"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Ferv.2753","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/erv.2753","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/erv.2753","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/erv.2753","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,3]],"date-time":"2023-09-03T14:38:00Z","timestamp":1693751880000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/erv.2753"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,15]]},"references-count":24,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2020,9]]}},"alternative-id":["10.1002\/erv.2753"],"URL":"https:\/\/doi.org\/10.1002\/erv.2753","archive":["Portico"],"relation":{},"ISSN":["1072-4133","1099-0968"],"issn-type":[{"value":"1072-4133","type":"print"},{"value":"1099-0968","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,6,15]]},"assertion":[{"value":"2019-07-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-05-19","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-06-15","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}