General discriminator | Original MTS | Modification | ||||
MTS flowchart | MTS discriminator | Urgency | Age group† | Urgency | Cut-off level‡ | |
Fever* | General and urinary problems | Hot child | Very urgent | 0–2 m | Very urgent | 80% |
>3 m | Urgent | 80% | ||||
Worried parent | 0–2 m | Very urgent | 80% | |||
3 m–3 y | Urgent | 80% | ||||
4–15 y | Standard | 80% | ||||
Sore throat, rashes and ear problems | 0–2 m | Very urgent | 80% | |||
3 m–15 y | Standard | 80% | ||||
Time since onset of symptoms | Falls, worried parent, sore throat, headache, rashes, eye problems | Recent problem§ | Standard | – | Non-urgent | 45% |
Persistent vomiting | General and vomiting and diarrhoea | Persistent vomiting | Urgent | 0–2 m | Urgent | – |
3 m–15 y | Standard | 75% | ||||
Specific discriminator | Shortness of breath in children | Unable to talk in sentences | Very urgent | – | Urgent | 80% |
Wheeze | Standard | – | Urgent | 60% (higher urgency than Standard) | ||
Head injury | Scalp haematoma | Standard | <1 y | Standard | ||
>1 y | Non-urgent | 65% | ||||
Worried parent | Not feeding | Urgent | <1 y | Urgent | ||
>1 y | Standard | 77% | ||||
Prolonged or uninterrupted crying | Urgent | <1 y | Urgent | |||
>1 y | Standard | 100% | ||||
Rashes | Moderate pain/itch | Urgent | – | Standard | 90% | |
Rash that does not fade when pressed/petechiae¶ | – | – | Very urgent | – |
↵* Fever is defined as body temperature above 38.5°C.
↵† m, months; y, years.
↵‡ Proportion of patients who were allocated to a lower urgency level, according to the reference standard, as compared with the original MTS urgency level.
↵§ Recent problem is defined as a problem arising in the last week.
↵¶ New discriminator.