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This study aimed to validate GEWS and compare its predictive accuracy with the NEWS, as well as to evaluate the clinical burden of predefined thresholds.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective multicenter observational study, patients receiving acute geriatric care were included. Clinical deterioration was defined as: (1) unexpected death, (2) Intensive Care Unit transfer, (3) transition to palliative care, or (4) urgent medical\/surgical intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 511 patients, 348 events occurred in 297 individuals. We found higher AUROC 0.796 [95% CI 0.770\u20130.822] and PR-AUC values 0.412 [95% CI 0.350\u20130.472] for GEWS compared to NEWS 0.732 [95% CI 0.697\u20130.765] and 0.305 [95% CI 0.249\u20130.365] respectively (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). The GEWS\u2009\u2265\u20095 compared to NEWS\u2009\u2265\u20095 was superior in accuracy (0.940 vs. 0.927), PPV (0.497 vs. 0.365), and specificity (0.977 vs. 0.967), (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). Moreover, a lower-number-needed-to-evaluate (NNE) (2.013 vs. 2.738,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001) and a higher alerted-outcome-event-rate (AOER 4.424 vs. 3.706, p\u2009&lt;\u20090.0005) resulted in lower clinical burden. For life-threatening events (Type 1\u20133), GEWS\u2009\u2265\u20098 compared to NEWS\u2009\u2265\u20097 showed higher specificity (0.999 vs. 0.995,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001) and reduced rate-of-alerts (ROA 0.518 vs.1.347,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>GEWS more accurately detects clinical deterioration within 12\u00a0h in frail older adults than NEWS, with less clinical burden. GEWS\u2009\u2265\u20095 is recommended for clinical alerting, whereas\u2009\u2265\u20098 for more urgent medical assistance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s41999-025-01316-7","type":"journal-article","created":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T02:49:27Z","timestamp":1759718967000},"page":"615-627","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Validation and performance of a geriatric early warning score (GEWS) versus the national early warning score (NEWS) in predicting clinical deterioration in frail older patients"],"prefix":"10.1007","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-9236-6117","authenticated-orcid":false,"given":"H.","family":"Baeyens","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1996-8786","authenticated-orcid":false,"given":"F.","family":"Haegdorens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Martens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0509-7414","authenticated-orcid":false,"given":"M. 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