Limited value of a patient-reported triage algorithm in an outpatient epilepsy clinic

The hypothesis of this study was that the patient-reported outcome (PRO) triage algorithm may be used as a screening tool to discriminate between patients who do and do not need a visit in the outpatient epilepsy clinic. The purpose of this study was to evaluate the validity of the triage algorithm by comparing it to an assessment made by a neurologist subspecialised in epilepsy.

A neurologist reviewed the answers to the PRO questionnaires, and, based on the severity of the answers, the neurologist assessed whether or not the patients should be reclassified into another triage colour group.

We found a significant difference between the triage of the neurologist and that of the PRO algorithm. The neurologist and PRO algorithm agreed regarding triage colour in 48.6% (37.4-59.9%) of the questionnaires (p less-than 0.0001). The neurologist and the PRO algorithm identified the same triage colour in 64.3% (38.8-83.7%) of the green baseline questionnaires (p less-than 0.0001), 46.7% (32.9-60.9%) of the yellow baseline questionnaires (p less-than 0.0001) and 38.5% (17.7-64.5%) of the red baseline questionnaires (p = 0.0016).

The neurologist assessment reduced the number of patients in the yellow triage group and increased patient numbers in the green and the red triage groups compared with the PRO triage algorithm. Major differences between the expert assessment and the PRO results were found. Improvement of PRO triage is needed before it may be used as a clinical management tool for patients with epilepsy.

none.

not relevant.