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They are less useful in detection of deterioration of initially healthy patients (e.elective surgical patients) in whom data collection is more limited. Thus, future research in this area needs to focus on such patients. These patients are likely to be younger, so even small increases in the ability to detect deterioration would result in substantial gains in terms of years of life saved.
Finally, as scores such as AAM and eCART are used in actual practice, data from patients who reach alert thresholds will be contaminated by clinician treatment in response to alerts.