A Web-Based Tool for Patient Triage in Emergency Department Settings: Validation Using the Emergency Severity Index
| Autor: | Pierre Elias, Ash Damle, Michael Casale, Kim Branson, Nick Peterson, Chaitanya Churi, Ravi Komatireddy, Jamison Feramisco |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
clinical decision support
Pediatrics medicine.medical_specialty Original Paper Future studies business.industry Concordance Computer applications to medicine. Medical informatics R858-859.7 Health Informatics Emergency department Gold standard (test) Triage Corrigenda and Addenda Emergency Severity Index Cohen's kappa Health Information Management Emergency medicine differential diagnosis medicine business triage emergency severity index Kappa |
| Zdroj: | JMIR Medical Informatics JMIR Medical Informatics, Vol 3, Iss 2, p e23 (2015) |
| ISSN: | 2291-9694 |
| Popis: | BackgroundWe evaluated the concordance between triage scores generated by a novel Internet clinical decision support tool, Clinical GPS (cGPS) (Lumiata Inc, San Mateo, CA), and the Emergency Severity Index (ESI), a well-established and clinically validated patient severity scale in use today. Although the ESI and cGPS use different underlying algorithms to calculate patient severity, both utilize a five-point integer scale with level 1 representing the highest severity. ObjectiveThe objective of this study was to compare cGPS results with an established gold standard in emergency triage. MethodsWe conducted a blinded trial comparing triage scores from the ESI: A Triage Tool for Emergency Department Care, Version 4, Implementation Handbook to those generated by cGPS from the text of 73 sample case vignettes. A weighted, quadratic kappa statistic was used to assess agreement between cGPS derived severity scores and those published in the ESI handbook for all 73 cases. Weighted kappa concordance was defined a priori as almost perfect (kappa > 0.8), substantial (0.6 < kappa < 0.8), moderate (0.4 < kappa < 0.6), fair (0.2 < kappa< 0.4), or slight (kappa < 0.2). ResultsOf the 73 case vignettes, the cGPS severity score matched the ESI handbook score in 95% of cases (69/73 cases), in addition, the weighted, quadratic kappa statistic showed almost perfect agreement (kappa = 0.93, 95% CI 0.854-0.996). In the subanalysis of 41 case vignettes assigned ESI scores of level 1 or 2, the cGPS and ESI severity scores matched in 95% of cases (39/41 cases). ConclusionsThese results indicate that the cGPS is a reliable indicator of triage severity, based on its comparison to a standardized index, the ESI. Future studies are needed to determine whether the cGPS can accurately assess the triage of patients in real clinical environments. |
| Databáze: | OpenAIRE |
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