Author | Quality | Systems | Method | Observation | Sens % (95% CI) | Sp % (95% CI) | PPV % (95% CI) | NPV% (95% CI) | LR (+) % (95% CI) | LR (−) % (95% CI) | Overtriage % | Undertriage % | AUC (95% CI) | OR (95% CI) |
Nijman, 201140 | ++/+++ | MTS | Association with serious bacterial infection | Ability to detect serious bacterial infection (SBI) | 42 (35 to 41) | 69 (66 to 72) | 14 (10 to 17) | 91 (89 to 93) | 1.35 (1.08 to 1.69) | 0.84 (0.73 to 0.98) | 0.57 (0.52 to 0.62) | |||
Seiger, 201443 | ++/+++ | Modified MTS 1 MTS 2 | MTS1 & MTS2 versus original MTS Association with hospitalisation | Ability to predict hospital admission | 1.1 (1.1 to 1.2) x 2.6 (2.4 to 2.9) | 0.80 (0.73 to 0.87) x 0.71 (0.68 to 0.74) | 0. 56 (0.55 to 0.58) x 0.66 (0.64 to 0.67) | 1.4 (1.2 to 1.6) x 3.7 (3.3 to 4.7) | ||||||
Twomey et al, 201312 | +/+++ | SATS | Association with hospitalisation | Ability to predict hospital admission | 91 | 54.5 | 37.5 | 95.3 | 45.5 | 9 | ||||
Mullan, 201446 | +/+++ | PATS | Association with hospitalisation | Overtriage and undertriage rates (see definitions below)* | 28.8* | 21.9* | ||||||||
Travers, 200934 | ++/+++ | ESI v.4 | Association with hospitalisation | Overtriage and undertriage rates (see definitions below)** | 16† | 11† | ||||||||
Hospital admission rate % (95% CI for the difference) RD % (SD) | ||||||||||||||
Gravel, 200847 | +++/+++ | PedCTAS | Association with hospital admission in febrile infants 3–36 months old | Hospital admission rate in downtriaged level 3 versus remaining level 3 and all level 4 | 2.4×2.8 (0.3 to 1.1) (downtriaged level 3 x all level 4) RD 13.1 to 2.4=10.7 (±1.9, p<0.001) (remaining level 3 - downtriaged level 3) | |||||||||
OR (95% CI) | ||||||||||||||
Van Veen, 201141 | +/+++ | MTS | Association of levels 4 and 5 with hospitalisation | Complaints associated with greater chance of hospital admission | Hospital admission 3.5% OR 3.0 (2.2 to 4.1)<1 year OR 2.5 (1.5 to 4.1) dyspnoea OR 3.5 (2.5 to 4.9) GI problem OR 2.8 (1.1 to 7.2) fever w/o source |
*Overtriage=PATS level 1 or 2 which were not admitted to hospital; undertriage=PATS level 4, which were admitted to hospital.
†Overtriage=ESI level 1, 2 or 3 which used <2 resources, or ESI level 1 which were not admitted to hospital; undertriage=ESI level 4 or 5 which used ≥2 resources or which were admitted to hospital.
Quality— +/+++: low quality; ++/+++: moderate quality; +++/+++: high quality.
AUC, area under the curve; ESI v.4, Emergency Severity Index version 4; LR (+), positive likelihood ratio; LR (−), negative likelihood ratio; MTS, Manchester Triage System; MTS1, modification in discriminators; MTS2, modification in vital signs; NPP, negative predictive value; PATS; Princess Marina Hospital Triage Scale; OR, odds ratio of prediction of hospital admission; PPV, positive predictive value; RD, risk difference; SATS, South African Triage Scale; Sens, sensitivity; Sp, specificity;