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Sepsis ImmunoScore sorted patients by sepsis risk in FDA's review

In FDA's review of the Prenosis Sepsis ImmunoScore, sepsis within 24 hours rose from 3.02% in its low risk category to 69.70% in its very high category; AUROC was 0.81.

Benefit status
Intended Read outcome assessment
Evidence
Found by a court or regulator
Source published
Sources
1 publication

Benefits

Benefit

An area under the ROC curve of 0.81

Awaiting review

Outcome identifiers

Unresolved

Not reviewedUnresolved

Category

Improved Task Accuracy

Awaiting review

Status

Intended. The validation applied the score retrospectively to stored data, and the score guided no care, so the sources report no realized benefit. [1]

Fully reviewed: supporting details for Status

Review date: 29 October 2026.

Sources: [1]

Beneficiary groups

Organizations.

Awaiting review

Beneficiaries

Unresolved

Not reviewedUnresolved

Reach

Unresolved

Not reviewedUnresolved

Distribution and access

Unresolved

Not reviewedUnresolved

Duration

Unresolved

Not reviewedUnresolved

Expected?

Yes

Awaiting review

Costs and harms

Unresolved

Not reviewedUnresolved

AI system

System

Sepsis ImmunoScore

Awaiting review

Model

This is an explicit unresolved assignment: the sources on record do not settle this question.

Not reviewedUnresolved

Release

Unresolved

Not reviewedUnresolved

Provider

Unresolved

Not reviewedUnresolved

Role

Unresolved

Not reviewedUnresolved

Configuration

Unresolved

Not reviewedUnresolved

Inputs and outputs

Unresolved

Not reviewedUnresolved

Autonomy

Unresolved

Not reviewedUnresolved

Workflow

The score used up to 22 inputs from the electronic health record, including a blood sample drawn within three hours of the first blood culture order. Risk thresholds were fixed before the validation study.

Awaiting review

Human oversight

Unresolved

Not reviewedUnresolved

Relation to AI

The study measured the accuracy of the score against physician adjudication. It did not compare care with and without the score.

Awaiting review

AI contribution

Unresolved

Not reviewedUnresolved

Measurement

Studies

Other. [1]

Fully reviewed: supporting details for Studies

Review date: 29 October 2026.

Sources: [1]

Study design

Other. [1]

Fully reviewed: supporting details for Study design

Review date: 29 October 2026.

Sources: [1]

Measurement

Retrospective study of prospectively collected data and samples; sepsis adjudicated by three physicians blinded to the score. [1]

Fully reviewed: supporting details for Measurement

Review date: 29 October 2026.

Sources: [1]

Setting and sample

746 patients with suspected sepsis at three US hospitals. [1]

Fully reviewed: supporting details for Setting and sample

Review date: 29 October 2026.

Sources: [1]

Measures

AUROC and sepsis rate by risk category. [1]

Fully reviewed: supporting details for Measures

Review date: 29 October 2026.

Sources: [1]

Comparison

Physician adjudication of Sepsis-3. [1]

Fully reviewed: supporting details for Comparison

Review date: 29 October 2026.

Sources: [1]

Results

AUROC 0.81; sepsis 3.02% low to 69.70% very high. [1]

Fully reviewed: supporting details for Results

Review date: 29 October 2026.

Sources: [1]

Additional value from AI

Not isolated. [1]

Fully reviewed: supporting details for Additional value from AI

Review date: 29 October 2026.

Sources: [1]

Limitations

Retrospective; same-site adjudicators; mechanical ventilation endpoint not met. [1]

Fully reviewed: supporting details for Limitations

Review date: 29 October 2026.

Sources: [1]

Denominators

One score per patient. [1]

Fully reviewed: supporting details for Denominators

Review date: 29 October 2026.

Sources: [1]

Materials for replication

None public. [1]

Fully reviewed: supporting details for Materials for replication

Review date: 29 October 2026.

Sources: [1]

Money

Kind of value

The kind of monetary value is unclear.

Not reviewedUnresolved

Amount

The monetary value is not established.

Not reviewedUnresolved

Currency and prices

The currency and price basis are unclear.

Not reviewedUnresolved

Period and unit

The period and unit of the monetary estimate are unclear.

Not reviewedUnresolved

Realization

Whether the monetary value was realized is unclear.

Not reviewedUnresolved

Recipients and payers

The recipients and payers are unclear.

Not reviewedUnresolved

Gross or net

Whether the monetary figure includes costs is unclear.

Not reviewedUnresolved

Included costs

The costs included in the estimate are unclear.

Not reviewedUnresolved

Comparison

The financial comparison is not established.

Not reviewedUnresolved

Method

The method used to calculate monetary value is unclear.

Not reviewedUnresolved

Return and payback

The return on investment or payback period is not established.

Not reviewedUnresolved

People and places

Participants

Developer: Prenosis, Inc. Operator: Prenosis (retrospective validation on data from three US hospitals).

Awaiting review

Jurisdictions

Benefit: Boston, Massachusetts; Chicago, Illinois; Royal Oak, Michigan, United States. Developer: United States. Operator: United States.

Awaiting review

Ownership and control

Unresolved

Not reviewedUnresolved

Dependencies

Unresolved

Not reviewedUnresolved

Cross-border connections

Unresolved

Not reviewedUnresolved

Geopolitical implications

The geopolitical implications are unclear.

Not reviewedUnresolved

Follow-up

Conditions for replication

The patient is an adult with suspected sepsis and a blood culture ordered. Clinicians use the score with other findings and not as the sole basis for a decision.

Awaiting review

Replication attempts

Unresolved

Not reviewedUnresolved

Later findings

Unresolved

Not reviewedUnresolved

Availability

Unresolved

Not reviewedUnresolved

Institutional decision

A relevant institutional decision has not been established.

Not reviewedUnresolved

Grounds

The grounds for an institutional decision are unclear.

Not reviewedUnresolved

Action and result

The result of an institutional decision is not established.

Not reviewedUnresolved

Success criterion

The criterion for a successful institutional decision is unclear.

Not reviewedUnresolved

Evidence

Source numbers

AIBD-0626-source-0001

Awaiting review

Citations

Numbered references below.

Awaiting review

Language

Unresolved

Not reviewedUnresolved

Source relationships

Independent

Awaiting review

Original evidence

Unresolved

Not reviewedUnresolved

Access and versions

Unresolved

Not reviewedUnresolved

Supported findings

Unresolved

Not reviewedUnresolved

Evidence strength

Found by a regulator. Sources: one independent regulatory document. The cited evidence includes no independent study or report. [1]

Fully reviewed: supporting details for Evidence strength

Review date: 29 October 2026.

Sources: [1]

Missing evidence

Unresolved

Not reviewedUnresolved

Grades

Assessed benefits

Organizations.

Awaiting review

Depth

The revised record no longer states this information.

Not reviewedUnresolved: supporting details for Depth

The record revision removed the mapped value.

Reasons

Organizations: The risk categories were measured on retrospective data, and no hospital used the score to change care.

Awaiting review

Observed or intended

Intended. The validation applied the score retrospectively to stored data, and the score guided no care, so the sources report no realized benefit. [1]

Fully reviewed: supporting details for Observed or intended

Review date: 29 October 2026.

Sources: [1]

Rubric

Unresolved

Not reviewedUnresolved

Assessor and date

Unresolved

Not reviewedUnresolved

Alternative assessments

Unresolved

Not reviewedUnresolved

Fill

Found by a regulator

Awaiting review

Entry details

Kind

The case describes an evaluation or a study. A regulatory review of a validation study. [1]

Fully reviewed: supporting details for Kind

Review date: 29 October 2026.

Sources: [1]

Field

Healthcare.

Awaiting review

Purpose

The Sepsis ImmunoScore was built to identify patients at risk of having or developing sepsis within 24 hours. The measured risk stratification is that purpose.

Awaiting review

Dates

Source published: 2 April 2024. Updated: 29 October 2026.

Awaiting review

Stage

The system was tested in a laboratory. Retrospective validation on biobank samples and records; the score did not guide care. [1]

Fully reviewed: supporting details for Stage

Review date: 29 October 2026.

Sources: [1]

Version

SHA-256: 88d1b88b8e1d…

Awaiting review: supporting details for Version

SHA-256 of the public case, its assessments, and its displayed answers and notes, excluding its own identifier and the derived coverage summary.

References

Other identifiers

AI Incident Database: 1374.

Awaiting review

Category mappings

Unresolved

Not reviewedUnresolved

Citable summary

Unresolved

Not reviewedUnresolved

Revisions

3 revisions. Latest: 29 October 2026.

Awaiting review

Sources

  1. Regulatory document Independent author

    U.S. Food and Drug Administration, Center for Devices and Radiological Health. De Novo classification request for Sepsis ImmunoScore (DEN230036): decision summary. Granted 2024-04-02.

Cite this case

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Version 88d1b88b8e1d, archived in the edition of 29 October 2026

Benefit marks

Depth

The number and color show the depth of a benefit.

  1. Depth 1. A convenience, or time or money saved.
  2. Depth 2. A measurable improvement in a result or ability.
  3. Depth 3. A lasting change, an ability restored, or a risk removed.
  4. Depth 4. A serious harm averted or a serious condition resolved in time.
  5. Depth 5. A life or livelihood preserved, or a change documented across a population.

Beneficiary

  • Circle: a person
  • Square: an organization
  • Triangle: society

Evidence

  • Solid. A court or regulator found a benefit, or researchers independently studied it.

  • Hatched. Independent reporting.

  • Outline. Claimed by the parties. Only the people or organizations involved, or sources whose independence has not been assessed, support the benefit.

The fill changes with the evidence. The depth color stays the same.

How benefits are assessed