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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)