Risk scores: which score to use and does it alter clinical management?

The debate began with an evaluation of the clinical utility of risk scoring systems in the assessment of UGIB. The Glasgow Blatchford score (GBS) is now the scoring system recommended by all the major recent international guidelines for identifying patients with very low-risk UGIB (GBS 0–1) who can be considered for outpatient management.3–5 Use of this score by clinicians in the emergency department (ED) or acute medical receiving unit allows early identification of low-risk patients who can avoid admission and have outpatient endoscopy arranged. The GBS gives junior doctors and our ED colleagues’ confidence to facilitate prompt decision making and avoid unnecessary hospital admissions.

In 2019, Shung et al used machine learning to develop a model that was able to identify patients admitted with UGIB who were at risk of requiring hospital-based intervention or death.6 This was found to have greater specificity and sensitivity than all the current clinical risk scoring systems. Further data on the clinical utility of this …