Validity of the Brazilian pediatric triage system CLARIPED at a secondary level of emergency care

Magalhães-Barbosa, Maria Clara de; Traldi, Paula de Camargo; Raymundo, Carlos Eduardo; Cunha, Antônio José Lêdo Alves da; Prata‐Barbosa, Arnaldo

doi:10.1016/j.jped.2022.10.005

Cited by 1 publication

(3 citation statements)

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“…Similar approach was mentioned in some other studies. 6,10 Third, waiting times of the patients in triage were not recorded. Because accurate measurement of vital findings in children is certainly more difficult and time consuming, our triage application times may have been longer than expected.…”

Section: Discussionmentioning

confidence: 99%

“…18 A pediatric triage tool named "SATS" was reported to have an overtriage rate of 45.5% and undertriage rate of 9%, 20 "CLARIPED" reported an overtriage rate of 59.1% and an undertriage rate of 7.4%. 6 An overtriage rate of 16% was reported for the ESI. 16 Although our overtriage and undertriage rates were within reasonable and acceptable limits when compared with PaedCTAS, overtriage rates were higher when compared with ESI.…”

Section: Discussionmentioning

confidence: 99%

“…4,5 It is emphasized that it is ideal for each country to use triage systems with high validity and reliability, which are formed by considering their own sociodemographic and cultural characteristics, provided that they benefit from internationally accepted triage decision support systems. 6 The intensity of the emergency services and inadequate experience of the triage personnel may negatively affect the right decision-making capacity. 7,8 For this reason, computerized systems should become widespread and standardized electronic triage decision support systems should be more accessible.…”

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confidence: 99%

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Evaluation of the Validity and Reliability of ANKUTRIAGE, a New Decision Support System in Pediatric Emergency Triage

et al. 2022

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Background:The intensity of emergency services is an increasing health problem all over the world, necessitating an effective triage system. The aim of this study was to evaluate the validity and reliability of the "ANKUTRIAGE" in children. Methods:This prospective, longitudinal study was carried out at a pediatric emergency department. ANKUTRIAGE, a 5-level computer-aided triage decision support system, was developed. Patients younger than 18 years who do not need emergency intervention, who had complete vital sign measurements, who gave consent for the study, and who were admitted to the emergency service during working hours with trained personnel were included. For validity, agreement between the urgency levels determined by ANKUTRIAGE and the reference triage systems: Pediatric Canadian Triage and Acuity Scale and Emergency Severity Index, was evaluated. In addition, the association of urgency levels with clinical outcomes was studied. To assess reliability, patients were evaluated by 2 blinded healthcare professionals using ANKUTRIAGE and a quadratic weighted κ was estimated.Results: A total of 1232 children with a median age of 4.00 years were included. ANKUTRIAGE acuity levels significantly correlated with the number of resources used, the number of patients undergoing life-saving procedures, pediatric intensive care unit, and overall hospitalization rates, respectively ( P < 0.001, P < 0.001, P < 0.001, P < 0.001). The agreement of ANKUTRIAGE with Pediatric Canadian Triage and Acuity Scale was found to be 0.94 (95% confidence interval [CI], 0.93-0.94), with an Emergency Severity Index of 0.75 (95% CI, 0.70-0.80). The interrater agreement between 2 evaluators who used ANKUTRIAGE reflected as excellent consistency 0.92 (95% CI, 0.89-0.95; κ > 0.8).Conclusions: ANKUTRIAGE demonstrated high agreement with clinical outcomes and with proven triage systems and reflected high reliability between users. ANKUTRIAGE will enable a more standardized and practical triage, especially in crowded pediatric emergency departments and in situations where triage is performed by health professionals with different experience and professions.

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Section: Discussionmentioning

confidence: 99%