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Article History

Received: 13 March 2024

Accepted: 22 December 2024

First Online: 3 February 2025

Competing interests

: H.L.E.'s PhD research focuses on developing data-driven latent measures of health status, which could potentially compete with or complement existing or future EWS. K.R. reports grants from Nova Scotia Health Research Fund, personal fees from Ardea Outcomes, the Chinese Medical Association, Wake Forest University Medical School Centre, the University of Nebraska - Omaha, the Australia New Zealand Society of Geriatric Medicine, the Atria Institute, Fraser Health Authority, McMaster University, and EpiPharma Inc, outside the submitted work; In addition, K.R. has licensed the Clinical Frailty Scale (CFS) (a latent measure of health) to Enanta Pharmaceuticals, Inc, Synairgen Research Ltd, Faraday Pharmaceuticals, Inc., KCR S.A., Icosavax, Inc, BioAge Labs Inc, Biotest AG, Qu Biologics Inc, AstraZeneca UK Ltd, Cellcolabs AB, Pfizer Inc, W.L. Gore Associates Inc, pending to Cook Research Incorporated and Rebibus Therapeutics Inc; has licensed the Pictorial Fit-Frail Scale (PFFS) to Congenica, and as part of Ardea Outcomes Inc has a pending patent for Electronic Goal Attainment Scaling. Use of both the CFS and PFFS is free for education, research and non-profit health care with completion of a permission agreement stipulating users will not change, charge for or commercialize the scales. For-profit entities (including pharma) pay a licensing fee, 15% of which is retained by the Dalhousie University Office of Commercialization and Innovation Engagement. The remainder of the license fees are donated to the Dalhousie Medical Research Foundation and the QEII Health Sciences Centre Research Foundation. In addition to academic and hospital appointments, K.R. is co-founder of Ardea Outcomes (DGI Clinical until 2021), which in the past 3 years has had contracts with pharma and device manufacturers (INmune, Novartis, Takeda) on individualized outcome measurement. J.T.T. has received research grant funding from National Institutes for Health Research (NIHR), Health Data Research UK (HDR), Innovate UK, Office of Life Sciences, Epilepsy Research Institute, British Heart Foundation, Responsible AI Adoption Unit, OneLondon Secure Data Environment, Kings Health Partners and Engineering & Physical Sciences Research Council (ESPRC). J.T.T. has also received research equipment support from Nvidia, Elastic and Scan Computing. J.T.T. is director and shareholder of CogStack Ltd. None of the funders had any say on the content of this work.