SEPSIS remains a medical emergency, but a new narrative review finds that no single screening tool reliably diagnoses it. A recent review of the literature (2019–2024) evaluated 26 studies of sepsis identification instruments in adult inpatients and emergency settings and concluded that available tools function largely as adjuncts to, rather than replacements for, clinical judgment.
The authors categorized tools into computerized clinical decision support systems, early warning scores in current use, and novel emerging instruments. Among early warning systems, National Early Warning Score versions 1 and 2 (NEWS/NEWS2) were the most widely used and had relatively stronger supporting evidence. Meanwhile, use of the quick Sequential Organ Failure Assessment (qSOFA) alone showed little evidence for accurate sepsis detection.
Computerized clinical decision support tools varied widely in design, and many were proprietary or specific to individual systems, limiting generalizability. These systems also lacked consensus on how best to report their diagnostic accuracy. Across all tool types, heterogeneous definitions of sepsis (e.g. Sepsis-2, Sepsis-3, combinations thereof, or administrative coding) made comparisons difficult.
Despite decades of development, the review underscores a sobering conclusion: no tool reliably identifies sepsis on its own. Instead, sepsis screening instruments should augment, not replace, clinical acumen. In practice, this means integrating tool outputs with careful bedside assessment and ensuring clear protocols. The review calls for standardization in reporting accuracy metrics and more rigorous evaluations, particularly of decision support systems, to improve adoption and utility.
Clinicians should be cautious about overreliance on any tool alone and continue emphasizing early recognition based on signs, symptoms, and judgment, supported by structured screening systems.
Reference: Seckel MA et al. Sepsis Identification Tools: A Narrative Review. Crit Care Nurse. 2025;45(5):63-79.
