{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T09:28:08Z","timestamp":1790760488986,"version":"4.1.0"},"reference-count":31,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2022,8,2]],"date-time":"2022-08-02T00:00:00Z","timestamp":1659398400000},"content-version":"unspecified","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,6,10]]},"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Identifying patients with a possible SARS-CoV-2 infection in the emergency department (ED) is challenging. Symptoms differ, incidence rates vary and test capacity may be limited. As PCR-testing all ED patients is neither feasible nor effective in most centres, a rapid, objective, low-cost early warning score to triage ED patients for a possible infection is developed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Case\u2013control study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Secondary and tertiary hospitals in the Netherlands.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>The study included patients presenting to the ED with venous blood sampling from July 2019 to July 2020 (n=10\u2009417, 279 SARS-CoV-2-positive). The temporal validation cohort covered the period from July 2020 to October 2021 (n=14\u2009080, 1093 SARS-CoV-2-positive). The external validation cohort consisted of patients presenting to the ED of three hospitals in the Netherlands (n=12\u2009061, 652 SARS-CoV-2-positive).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary outcome measures<\/jats:title>\n                    <jats:p>The primary outcome was one or more positive SARS-CoV-2 PCR test results within 1\u2009day prior to or 1\u2009week after ED presentation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The resulting \u2018CoLab-score\u2019 consists of 10 routine laboratory measurements and age. The score showed good discriminative ability (AUC: 0.930, 95%\u2009CI 0.909 to 0.945). The lowest CoLab-score had high sensitivity for COVID-19 (0.984, 95%\u2009CI 0.970 to 0.991; specificity: 0.411, 95%\u2009CI 0.285 to 0.520). Conversely, the highest score had high specificity (0.978, 95%\u2009CI 0.973 to 0.983; sensitivity: 0.608, 95%\u2009CI 0.522 to 0.685). The results were confirmed in temporal and external validation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The CoLab-score is based on routine laboratory measurements and is available within 1\u2009hour after presentation. Depending on the prevalence, COVID-19 may be safely ruled out in over one-third of ED presentations. Highly suspect cases can be identified regardless of presenting symptoms. The CoLab-score is continuous, in contrast to the binary outcome of lateral flow testing, and can guide PCR testing and triage ED patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-059111","type":"journal-article","created":{"date-parts":[[2022,8,3]],"date-time":"2022-08-03T11:42:06Z","timestamp":1659526926000},"page":"e059111","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Development and validation of an early warning score to identify COVID-19 in the emergency department based on routine laboratory tests: a multicentre case\u2013control study"],"prefix":"10.1136","volume":"12","author":[{"given":"Arjen-Kars","family":"Boer","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine, Catharina Hospital, Eindhoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6011-7783","authenticated-orcid":false,"given":"Ruben","family":"Deneer","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Catharina Hospital, Eindhoven, The Netherlands"},{"name":"Faculty of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maaike","family":"Maas","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Catharina Hospital, Eindhoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi S M","family":"Ammerlaan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Catharina Hospital, Eindhoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland H H","family":"van Balkom","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Diseases, Catharina Hospital, Eindhoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy A H M","family":"Thijssen","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Catharina Ziekenhuis, Eindhoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Bennenbroek","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Catharina Ziekenhuis, Eindhoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5186-5600","authenticated-orcid":false,"given":"Mathie","family":"Leers","sequence":"additional","affiliation":[{"name":"Department of Clinical Chemistry and Hematology, Zuyderland Medical Centre Heerlen, Heerlen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Remy J H","family":"Martens","sequence":"additional","affiliation":[{"name":"Department of Clinical Chemistry and Hematology, Zuyderland Medical Centre Heerlen, Heerlen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madelon M","family":"Buijs","sequence":"additional","affiliation":[{"name":"Atalmedial Diagnostic Centers, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos J","family":"Kerremans","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Infection Prevention, Alrijne Hospital, Leiderdorp, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muri\u00ebl","family":"Messchaert","sequence":"additional","affiliation":[{"name":"Department of Clinical Chemistry, Gelre Hospitals, Apeldoorn, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeroen J","family":"van Suijlen","sequence":"additional","affiliation":[{"name":"Department of Clinical Chemistry, Gelre Hospitals, Apeldoorn, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natal A W","family":"van Riel","sequence":"additional","affiliation":[{"name":"Faculty of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands"},{"name":"Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Volkher","family":"Scharnhorst","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Catharina Hospital, Eindhoven, The Netherlands"},{"name":"Faculty of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,8,3]]},"reference":[{"key":"2025121510331410000_12.8.e059111.1","unstructured":"Disease C . 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