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Table 1 Studies on reliability of the ESI, CTAS, MTS and ATS in paediatric emergency care

From: Reliability and validity of triage systems in paediatric emergency care

Country N scenarios,
raters
(response rate)*
Triage system/population Study design Results
Australia [34] 14 scenarios,
178 nurses**
ATS, children 7 paper, 7 computer based scenarios K 0.40 (paper)
K 0.58 (computer)
Australia [35] 8 scenarios,
97 nurses (44%)
ATS, children Written case scenarios K 0.21
USA [6] 20 scenarios ESI version 3, children Written case scenarios Kw 0.84–1.00
USA [6] 272 patients ESI version 3, children Simultaneous triage Kw 0.59 (95% CI 0.55–0.63)
Canada [9] 54 scenarios,
18 nurses (62%)
PaedCTAS
children
Written case scenarios Kw 0.51 (95% CI 0.50–0.52)
Canada [10] 499 patients PaedCTAS
children
Simultaneous triage Lineair Kw 0.55 (95% CI 0.48–0.61)
Quadratic Kw 0.61 (95% CI 0.42–0.80)
The Netherlands [15] 50 scenarios,
48 nurses (87%)
MTS adults and children Written case scenarios Kw 0.62
The Netherlands [17] 20 scenarios,
43 nurses (100%)
198 patients
MTS in children Written case scenarios
Simultaneous triage
Quadratic Kw 0.83 (95% CI 0.74–0.91)
Quadratic Kw 0.65 (95% CI 0.56–0.72)
  1. * For studies using the written case scenario method
  2. ** Compliance rate not described in paper † N raters and compliance rate not described in paper
  3. ‡ K kappa, Kw Weighted kappa,
  4. ATS = Australasian Triage Scale, ESI = Emergency Severity Index, MTS = Manchester Triage System, PaedCTAS = Paediatric Canadian Triage and Acuity Scale
  5. Kappa/weighted kappa: poor if K ≤ 0.20, Fair if 0.21 ≤ K ≤ 0.40, moderate if 0.41 ≤ K ≤ 0.60, good if 0.61 ≤ K ≤ 0.80 very good if K>0.80. (95% confidence interval)