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Table 3 Reliability of triage scales

From: Emergency Department Triage Scales and Their Components: A Systematic Review of the Scientific Evidence

Author Year, reference Country

Triage system

Patient characteristics: Age Gender Triageur: Amount, profession

Results: κ-values, percentage agreement (PA)/triage level

Drop out (%)

Study quality and relevance

Considine J et al

2000, [26]

Australia

ATS

10 scenarios

31 RNs

Triage level:

1: 59.7% PA

2: 58% PA

3: 79% PA

4: 54.8% PA

5: 38.7% PA

0%

Low

External validity is uncertain, internal validity is good while sample size is of uncertain adequacy

Dong S et al

2006, [28]

Canada

ETriage (CTAS)

569 patients

49.4 years

51 % male

Unknown amount of RNs

0.40 (unweighted κ)

Triage level:

1: 62.5% PA

2: 49.5% PA

3: 59.7% PA

4: 68.5% PA

5: 43.5% PA

1%

Low

External validity can not be assessed, internal validity is excellent while sample size is of uncertain adequacy

Dong S et al

2005, [29]

Canada

CTAS/eTriage

693 patients

48 years

49 % male

73 RNs

0.202 (unweighted κ)

Triage level:

1: 50% PA

2: 9% PA

3: 53.5% PA

4: 73.3% PA

5: 7.2% PA

4%

Low

External validity can not be assessed, internal validity is excellent while sample size is of uncertain adequacy

Manos D et al

2002, [30]

Canada

CTAS

42 scenarios

5 BLS

5 ALS

5 RNs

5 Drs

0.77 overall (weighted κ)

BLS: 0.76 (weighted κ)

ALS: 0.73 (weighted κ)

RNs: 0.80 (weighted κ)

Drs: 0.82 (weighted κ)

Triage level:

1: 78% PA

2: 49% PA

3: 37% PA

4: 41% PA

5: 49% PA

0.2%

Low

External validity can not be assessed, internal validity is acceptable while sample size is of uncertain adequacy

Beveridge R et al

1999, [27]

Canada

CTAS

50 scenarios

10 RNs

10 Drs

0.80 overall (weighted κ)

0.84 RNs (weighted κ)

0.83 Drs (weighted κ)

Weighted κ / triage level (RNs):

Triage level:

1: 0.73

2: 0.52

3: 0.57

4: 0.55

5: 0.66

15%

Low

External validity can not be assessed, internal validity is acceptable while sample size is of uncertain adequacy

Göransson K et al

2005, [19]

Sweden

CTAS

18 scenarios

423 RNs

0.46 (unweighted κ)

Triage level:

1: 85.4% PA

2: 39.5% PA

3: 34.9% PA

4: 32.1% PA

5: 65.1% PA

0.8%

Low

External validity can not be assessed, internal validity is acceptable while sample size is of uncertain adequacy

van der Wulp I et al

2008, [31]

The Netherlands

MTS

50 scenarios

55 RNs

0.48 (unweighted κ)

Triage level:

2: 9.8% PA

3: 35.5% PA

4: 22% PA

7.5-35.7%

Low

External validity is uncertain, internal validity is good while sample size is of uncertain adequacy

Maningas P et al

2006, [6]

USA

SRTS

423 patients

29.7 years

44% male

16 RN pairs

0.87 (weighted κ)

Triage level:

1: 85.7% PA

2: 86.7% PA

3: 86.8% PA

4: 93.9% PA

5: 74.2% PA

 

Low

External validity can not be assessed, internal validity is good while sample size is of uncertain adequacy

Rutschmann OT et al

2006, [8]

Switzerland

4-tier system

22 patient scenarios

45 RNs

8 Drs

RNs: 0.40 (weighted κ)

Drs: 0.28 (weighted κ)

Triage level:

1: 61% PA

2: 49.6% PA

3: 74.2% PA

4: 75.5% PA

4%

0%

Low

External validity is uncertain, internal validity is excellent while sample size is of uncertain adequacy

Brillman J et al

1996, [32]

USA

4-tier system

5 123 patients

64% < 35 years

54% male

Unknown amount of RNs and Drs

0.45 (unknown type of κ)

Triage level:

1: 0.13% PA

2: 5.2% PA

3: 37.9% PA

4: 24.6% PA

10%

Moderate

External validity is clear, internal validity is good while sample size is of uncertain adequacy

  1. ATS = Australasian Triage Scale; CTAS = Canadian Emergency Department Triage and Acuity Scale; MTS = Manchester Triage Scale; SRTS = Soterion Rapid Triage Scale; RNs = registered nurses; Drs = doctors; BLS = Basic Life Support; ALS = Advanced Life Support