Fig. 5

Decision curves comparing the net benefit of SIRS criteria, qSOFA, NEWS and REMS for patients with suspected sepsis at risk of (a) in-hospital mortality and (b) mortality within 7 days of admission over a plausible range of threshold probabilities. SIRS criteria (blue line), qSOFA (yellow line), NEWS (green line), and REMS (orange line), a ‘treat all’ strategy (black dashed and dotted line), and a ‘treat none’ strategy (black dashed line). Net benefit = (true-positive classifications – harm/cost-to-benefit ratio × false-positive classifications) ÷ N. The threshold probability represents the number of patients that the physician is willing to treat. Net reduction in interventions per 100 patients in a theoretical population for (c) in-hospital mortality and (d) mortality within 7 days of admission. The distribution of non-events of the outcome (0) and events of the outcome (1) by expected probability are denoted by the rug plot (light grey) along the x axis. Abbreviations: NEWS, National Early Warning Score; qSOFA, quick Sequential Organ Failure Assessment; REMS, Rapid Emergency Medicine Score; SIRS, systemic inflammatory response syndrome