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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