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Are Pediatric Triage Systems Reliable in the Emergency Department?
Mohsen Ebrahimi1, Amir Mirhaghi2, Zohre Najafi3
1Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Pediatric triage scales (PTSs) show substantial inter-rater reliability, with an overall agreement coefficient of 0.727. This level of agreement is acceptable for use in pediatric emergency departments.
Area of Science:
- Emergency Medicine
- Pediatric Care
- Health Services Research
Background:
- Limited research exists on the agreement levels of pediatric triage scales (PTSs).
- Inter-rater reliability is crucial for consistent patient assessment in emergency settings.
Purpose of the Study:
- To conduct a meta-analytic review examining the inter-rater reliability of pediatric triage scales.
- To synthesize existing evidence on the agreement levels of various PTSs.
Main Methods:
- Systematic search of electronic databases up to March 2019.
- Inclusion of studies reporting reliability coefficients and sample sizes, assessed using COSMIN standards.
- Meta-analysis using random-effects models and z-transformation of reliability coefficients.
Main Results:
- Thirteen studies were included in the meta-analysis.
- The pooled agreement coefficient for PTSs was 0.727 (95% CI: 0.650-0.790), indicating substantial reliability.
- Specific scales showed varying agreement: ATS (0.25), CTAS (0.571), ESI (0.810), and MTS (0.755).
Conclusions:
- The overall reliability of pediatric triage systems is substantial and acceptable for clinical use.
- Findings support the consistent application of PTSs in pediatric emergency departments.
- Further research is recommended to explore agreement levels in pediatric triage systems.
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