The Triage Capability of Laypersons: Retrospective Exploratory Analysis

Area of Science:

• Medical decision-making
• Health services research
• Patient self-assessment

Background:

• Laypersons independently make critical health decisions, including initial triage.
• Overly cautious (overtriaging) or imprudent (undertriaging) self-assessments pose risks.
• Symptom checkers are emerging tools to aid patient triage decisions.

Purpose of the Study:

• To identify factors influencing laypersons' self-triage accuracy.
• To understand risk aversion in layperson triage decisions.
• To explore sociodemographic influences on triage behavior.

Main Methods:

• Analysis of 91 laypersons appraising 45 case vignettes (N=4095 appraisals).
• Application of signal detection theory and statistical analyses.
• Distinction between decisions on emergency care need and self-care sufficiency.

Main Results:

• Emergency detection accuracy (82.2%) was higher than identifying any needed care (75.9%).
• Females exhibited greater risk aversion and overtriaging compared to males.
• Triage accuracy increased with certainty, yet most errors occurred when participants felt certain.

Conclusions:

• Laypersons tend to be overly cautious but also miss significant emergencies.
• Women demonstrate higher risk aversion in triage decisions than men.
• Certainty in appraisal correlates with increased triage errors, potentially limiting the utility of decision support tools.