Early warning system that uses nurses' notes to spot hospitalized adults who may get sicker

Communicating Narrative Concerns Entered by RNs (CONCERN)

NIH-funded research Columbia University Health Sciences · NIH-11266137

A computer program reads nurses' documentation to alert doctors and nurses earlier when hospitalized adults are at risk of worsening.

Quick facts

Grant typeR01 grant
Study typeNIH-funded research
Funding institutionColumbia University Health Sciences NIH-funded
Lab location1 site (New York, United States)
Project IDNIH-11266137 on NIH RePORTER

What this research studies

If I'm hospitalized, this system looks at patterns in nurses' notes and actions to notice when nurses are becoming more concerned about a patient. It combines expert knowledge with machine learning to produce an early warning score that can alert clinicians sooner than standard tools. An earlier randomized trial of the system linked its alerts to a 27% lower chance of inpatient death and flagged risk about 42 hours before a leading early warning score. This renewal will implement the system at five academic hospitals to check how well it works across different patient groups, whether it is fair, and how caregiver-provided information contributes to the alerts.

Who could benefit from this research

Good fit: Adults (21+) admitted to one of the participating academic medical centers who receive nursing care on wards or in emergency/admission settings.

Not a fit: Children, outpatients, or patients treated at hospitals that do not use the CONCERN system would not directly benefit from this project.

Why it matters

Potential benefit: Could help clinicians detect patient deterioration earlier, potentially reducing deaths and serious complications in hospitalized adults.

How similar studies have performed: A prior randomized trial of CONCERN showed interim results of a 27% reduced inpatient mortality and earlier alerts compared with a common early warning score, indicating promising prior success.

Where this research is happening

New York, United States

Researchers

About this research

  1. This is an active NIH-funded research project — typically early-stage science, not a clinical trial accepting patient enrollment.
  2. Some NIH-funded labs run parallel clinical studies or seek volunteers for related work. To check, contact the principal investigator or institution listed above.
  3. For full project details, budget, and progress reports, visit the official NIH RePORTER page below.
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.