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Updated: Sep 18, 2025

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InfoKids+: A Validation Study of a Pediatric Acuity Risk Stratification Algorithm.

Carl A Starvaggi1,2,3, Sophie Affentranger1,4, Noelie Lengeler1,5

  • 1Division of Pediatric Emergency Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, Bern, Switzerland.

Mayo Clinic Proceedings. Digital Health
|June 26, 2025
PubMed
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This summary is machine-generated.

The InfoKids+ pediatric risk stratification algorithm showed poor agreement with nurse-based triage, leading to significant over-referrals. Rigorous validation is crucial before deploying such electronic risk stratification algorithms.

Area of Science:

  • Pediatric Emergency Medicine
  • Health Informatics
  • Clinical Decision Support Systems

Background:

  • Pediatric emergency departments (PEDs) face challenges in efficiently and accurately stratifying patient acuity.
  • Electronic risk stratification algorithms (eRSAs) offer potential solutions but require thorough validation.
  • The InfoKids+ eRSA was developed based on the InfoKids parental guidance application.

Purpose of the Study:

  • To prospectively validate the performance of the InfoKids+ pediatric acuity electronic risk stratification algorithm (eRSA).
  • To compare the InfoKids+ eRSA's triage accuracy against a standard nurse-based triage system (nbTS).

Main Methods:

  • A prospective validation study was conducted in a Swiss university hospital's PED.
  • 1990 participants' acuity levels were assessed using InfoKids+ and compared to nbTS.

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  • Primary outcomes included level of agreement and rate of alignment between the two triage methods.

    • Main Results:

    • InfoKids+ demonstrated slight agreement with the nbTS (κlw=0.08).
    • Significant discrepancies were observed in triage urgency: InfoKids+ classified 89% as urgent vs. 41% by nbTS (P<.001).
    • Alignment with the reference standard occurred in only 45% of cases, with 50% over-referrals and 5% under-referrals.

    Conclusions:

    • The InfoKids+ eRSA exhibited notable discrepancies when compared to conventional nurse-based triage.
    • The findings underscore the necessity for rigorous validation of eRSAs for accuracy and patient safety.
    • Ensuring the safety and efficacy of algorithmic triage tools is critical to prevent harm and optimize resource allocation.