Sensitivity and specificity of the Manchester Triage System in risk prioritization of patients with acute myocardial infarction who present with chest pain

Nishi, Fernanda Ayache; Polak, Catarina; Cruz, Diná de Almeida Lopes Monteiro da

doi:10.1177/1474515118777402

Cited by 23 publications

(33 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As with other papers that have explored the performance of MTS, the breakpoint chosen for the dichotomisation and used to assess its validity for identifying high‐risk AAP patients was orange and red (Gräff et al, 2017; Nishi et al, 2018). This seems natural considering the strong outcomes chosen (short‐term mortality and surgery) and the need to explore the safety of the system as a prerogative of its validity.…”

Section: Discussionmentioning

confidence: 99%

“…It prioritises patients accessing the ED according to five increasing risk categories depending on the signs and symptoms at the time of ED admission (Pinto et al, 2012). Recent studies have shown a good predictive ability of the MTS for acute coronary syndrome risk in patients with chest pain (Nishi et al, 2018); however, recently MTS has proven to be lacking in more specific areas such as sepsis but no evaluation of MTS performance has yet been conducted in patients with AAP (Gräff et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Acute abdominal pain in triage: A retrospective observational study of the Manchester triage system’s validity

Zaboli

Ausserhofer

Pfeifer

et al. 2021

Journal of Clinical Nursing

View full text Add to dashboard Cite

Objective Roughly 5% to 10% of patients admitted to the emergency department suffer from acute abdominal pain. Triage plays a key role in patient stratification, identifying patients who need prompt treatment versus those who can safely wait. In this regard, the aim of this study was to estimate the performance of the Manchester Triage System in classifying patients with acute abdominal pain. Methods A total of 9,851 patients admitted at the Emergency Department of the Merano Hospital with acute abdominal pain were retrospectively enrolled between 1 January 2017 and 30 June 2019. The study was conducted and reported according to the STROBE statement. The sensitivity and specificity of the Manchester Triage System were estimated by verifying the triage classification received by the patients and their survival at seven days or the need for acute surgery within 72 h after emergency department access. Results Among the patients with acute abdominal pain (median age 50 years), 0.4% died within seven days and 8.9% required surgery within 72 hours. The sensitivity was 44.7% (29.9–61.5), specificity was 95.4% (94.9–95.8), and negative predictive value was 99.7% (99.2–100) in relation to death at seven days. Conclusions The Manchester Triage System shows good specificity and negative predictive value. However, its sensitivity was low due to the amount of incorrect triage prediction in patients with high‐priority codes (red/orange), suggesting overtriage in relation to seven‐day mortality. This may be a protective measure for the patient. In contrast, the need for acute surgery within 72 h was affected by under‐triage. Relevance to clinical practice The triage nurse using Manchester Triage System can correctly prioritise the majority of patients with acute abdominal pain, especially in low acuity patients. The Manchester Triage System is safe and does not underestimate the severity of the patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Acute abdominal pain in triage: A retrospective observational study of the Manchester triage system’s validity

Zaboli

Ausserhofer

Pfeifer

et al. 2021

Journal of Clinical Nursing

View full text Add to dashboard Cite

show abstract

“…As described previously, many studies assessed the accuracy of other triage systems [22], and some of these also used clinical outcomes as the reference [24][25][26][27][28][29][30][31].…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

“…chest pain), some of which included clinical outcomes as the reference (e.g. acute coronary syndrome), yet, only in ED settings [24][25][26][27][28][29][30][31]. Comparable accuracy studies in primary care settings are limited; one study that assessed the overall accuracy of a telephone triage tool in primary care used a 'surrogate' reference created by the researchers themselves (e.g.…”

Section: Introductionmentioning

confidence: 99%

Accuracy of telephone triage in patients suspected of transient ischaemic attack or stroke: a cross-sectional study

et al. 2020

View full text Add to dashboard Cite

Background The Netherlands Triage Standard (NTS) is a widely used decision support tool for telephone triage at Dutch out-of-hours primary care services (OHS-PC), which, however, has never been validated against clinical outcomes. We aimed to determine the accuracy of the NTS urgency allocation for patients with neurological symptoms suggestive of a transient ischaemic attack (TIA) or stroke, with the clinical outcomes TIA, stroke, and other (neurologic) life-threatening events (LTEs) as the reference. Method A cross-sectional study of telephone triage recordings of patients with neurological symptoms calling the OHS-PC between 2014 and 2016.The allocated NTS urgencies were derived from the electronic medical records of the OHS-PC. The clinical outcomes were retrieved from the electronic medical records of the patients’ own general practitioners. The accuracy of a high NTS urgency allocation (medical help within 3 h) was calculated in terms of sensitivity, specificity, positive and negative predictive values (PPV and NPV) with the clinical outcomes TIA/stroke/other LTEs as the reference. Results Of 1269 patients, 635 (50.0%) received the diagnosis TIA/stroke (34.2% TIA/minor stroke, 15.8% major ischaemic or haemorrhagic stroke), and 4.8% other LTEs. For TIA/stroke/other LTEs, the sensitivity and specificity of the NTS urgency allocation were 0.72 (95%CI 0.68–0.75) and 0.48 (95%CI 0.43–0.52), and the PPV and NPV were 0.62 (95%CI 0.60–0.64) and 0.58 (95%CI 0.54–0.62). Conclusions The NTS decision support tool used in Dutch OHS-PC performed poor to moderately regarding safety (sensitivity) and efficiency (specificity) in allocating adequate urgencies to patients with and without TIA/stroke/other LTEs. Trial registration The Netherlands National Trial Register, identification number NTR7331 /Trial NL7134.

show abstract

“…acute coronary syndrome), yet, only in ED settings. (24)(25)(26)(27)(28)(29)(30)(31) Comparable accuracy studies in primary care settings are limited; one study that assessed the overall accuracy of a telephone triage tool in primary care used a 'surrogate' reference created by the researchers themselves (e.g. hospital referrals or costs).…”

Section: Introductionmentioning

confidence: 99%

Accuracy of telephone triage in patients suspected of transient ischaemic attack or stroke: A cross-sectional study

Erkelens

Rutten

Wouters

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: The Netherlands Triage Standard (NTS) is a widely used decision support tool for telephone triage at Dutch out-of-hours primary care services (OHS-PC), which, however, has never been validated against clinical outcomes. We aimed to determine the accuracy of the NTS urgency allocation for patients with neurological symptoms suggestive of a transient ischaemic attack (TIA) or stroke, with the clinical outcomes TIA, stroke, and other (neurologic) life-threatening events (LTEs) as the reference. Method: A cross-sectional study of telephone triage recordings of patients with neurological symptoms calling the OHS-PC between 2014 and 2016.The allocated NTS urgencies were derived from the electronic medical records of the OHS-PC. The clinical outcomes were retrieved from the electronic medical records of the patients’ own general practitioners. The accuracy of a high NTS urgency allocation (medical help within three hours) was calculated in terms of sensitivity, specificity, positive and negative predictive values (PPV and NPV) with the clinical outcomes TIA/stroke/other LTEs as the reference. Results: Of 1,269 patients, 635 (50.0%) received the diagnosis TIA/stroke (34.2% TIA/minor stroke, 15.8% major ischaemic or haemorrhagic stroke), and 4.8% other LTEs. For TIA/stroke/other LTEs, the sensitivity and specificity of the NTS urgency allocation were 0.72 (95%CI 0.68-0.75) and 0.48 (95%CI 0.43-0.52), and the PPV and NPV were 0.62 (95%CI 0.60-0.64) and 0.58 (95%CI 0.54-0.62). Conclusions: The NTS decision support tool used in Dutch OHS-PC performed poor to moderately regarding safety (sensitivity) and efficiency (specificity) in allocating adequate urgencies to patients with and without TIA/stroke/other LTEs.

show abstract

Sensitivity and specificity of the Manchester Triage System in risk prioritization of patients with acute myocardial infarction who present with chest pain

Cited by 23 publications

References 11 publications

Acute abdominal pain in triage: A retrospective observational study of the Manchester triage system’s validity

Acute abdominal pain in triage: A retrospective observational study of the Manchester triage system’s validity

Accuracy of telephone triage in patients suspected of transient ischaemic attack or stroke: a cross-sectional study

Accuracy of telephone triage in patients suspected of transient ischaemic attack or stroke: A cross-sectional study

Contact Info

Product

Resources

About