A Web-Based Tool for Patient Triage in Emergency Department Settings: Validation Using the Emergency Severity Index
BackgroundWe evaluated the concordance between triage scores generated by a novel Internet clinical decision support tool, Clinical GPS (cGPS) (Lumiata Inc, San Mateo, CA), and the Emergency Severity Index (ESI), a well-established and clinically validated patient severity scale in use today. Altho...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JMIR Publications
2015-06-01
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| Series: | JMIR Medical Informatics |
| Online Access: | http://medinform.jmir.org/2015/2/e23/ |
| _version_ | 1818565826855305216 |
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| author | Elias, Pierre Damle, Ash Casale, Michael Branson, Kim Peterson, Nick Churi, Chaitanya Komatireddy, Ravi Feramisco, Jamison |
| author_facet | Elias, Pierre Damle, Ash Casale, Michael Branson, Kim Peterson, Nick Churi, Chaitanya Komatireddy, Ravi Feramisco, Jamison |
| author_sort | Elias, Pierre |
| collection | DOAJ |
| description | BackgroundWe evaluated the concordance between triage scores generated by a novel Internet clinical decision support tool, Clinical GPS (cGPS) (Lumiata Inc, San Mateo, CA), and the Emergency Severity Index (ESI), a well-established and clinically validated patient severity scale in use today. Although the ESI and cGPS use different underlying algorithms to calculate patient severity, both utilize a five-point integer scale with level 1 representing the highest severity.
ObjectiveThe objective of this study was to compare cGPS results with an established gold standard in emergency triage.
MethodsWe conducted a blinded trial comparing triage scores from the ESI: A Triage Tool for Emergency Department Care, Version 4, Implementation Handbook to those generated by cGPS from the text of 73 sample case vignettes. A weighted, quadratic kappa statistic was used to assess agreement between cGPS derived severity scores and those published in the ESI handbook for all 73 cases. Weighted kappa concordance was defined a priori as almost perfect (kappa > 0.8), substantial (0.6 < kappa < 0.8), moderate (0.4 < kappa < 0.6), fair (0.2 < kappa< 0.4), or slight (kappa < 0.2).
ResultsOf the 73 case vignettes, the cGPS severity score matched the ESI handbook score in 95% of cases (69/73 cases), in addition, the weighted, quadratic kappa statistic showed almost perfect agreement (kappa = 0.93, 95% CI 0.854-0.996). In the subanalysis of 41 case vignettes assigned ESI scores of level 1 or 2, the cGPS and ESI severity scores matched in 95% of cases (39/41 cases).
ConclusionsThese results indicate that the cGPS is a reliable indicator of triage severity, based on its comparison to a standardized index, the ESI. Future studies are needed to determine whether the cGPS can accurately assess the triage of patients in real clinical environments. |
| first_indexed | 2024-12-14T01:45:55Z |
| format | Article |
| id | doaj.art-d966630e0da149859cdf700cdadd3390 |
| institution | Directory Open Access Journal |
| issn | 2291-9694 |
| language | English |
| last_indexed | 2024-12-14T01:45:55Z |
| publishDate | 2015-06-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR Medical Informatics |
| spelling | doaj.art-d966630e0da149859cdf700cdadd33902022-12-21T23:21:34ZengJMIR PublicationsJMIR Medical Informatics2291-96942015-06-0132e2310.2196/medinform.3508A Web-Based Tool for Patient Triage in Emergency Department Settings: Validation Using the Emergency Severity IndexElias, PierreDamle, AshCasale, MichaelBranson, KimPeterson, NickChuri, ChaitanyaKomatireddy, RaviFeramisco, JamisonBackgroundWe evaluated the concordance between triage scores generated by a novel Internet clinical decision support tool, Clinical GPS (cGPS) (Lumiata Inc, San Mateo, CA), and the Emergency Severity Index (ESI), a well-established and clinically validated patient severity scale in use today. Although the ESI and cGPS use different underlying algorithms to calculate patient severity, both utilize a five-point integer scale with level 1 representing the highest severity. ObjectiveThe objective of this study was to compare cGPS results with an established gold standard in emergency triage. MethodsWe conducted a blinded trial comparing triage scores from the ESI: A Triage Tool for Emergency Department Care, Version 4, Implementation Handbook to those generated by cGPS from the text of 73 sample case vignettes. A weighted, quadratic kappa statistic was used to assess agreement between cGPS derived severity scores and those published in the ESI handbook for all 73 cases. Weighted kappa concordance was defined a priori as almost perfect (kappa > 0.8), substantial (0.6 < kappa < 0.8), moderate (0.4 < kappa < 0.6), fair (0.2 < kappa< 0.4), or slight (kappa < 0.2). ResultsOf the 73 case vignettes, the cGPS severity score matched the ESI handbook score in 95% of cases (69/73 cases), in addition, the weighted, quadratic kappa statistic showed almost perfect agreement (kappa = 0.93, 95% CI 0.854-0.996). In the subanalysis of 41 case vignettes assigned ESI scores of level 1 or 2, the cGPS and ESI severity scores matched in 95% of cases (39/41 cases). ConclusionsThese results indicate that the cGPS is a reliable indicator of triage severity, based on its comparison to a standardized index, the ESI. Future studies are needed to determine whether the cGPS can accurately assess the triage of patients in real clinical environments.http://medinform.jmir.org/2015/2/e23/ |
| spellingShingle | Elias, Pierre Damle, Ash Casale, Michael Branson, Kim Peterson, Nick Churi, Chaitanya Komatireddy, Ravi Feramisco, Jamison A Web-Based Tool for Patient Triage in Emergency Department Settings: Validation Using the Emergency Severity Index JMIR Medical Informatics |
| title | A Web-Based Tool for Patient Triage in Emergency Department Settings: Validation Using the Emergency Severity Index |
| title_full | A Web-Based Tool for Patient Triage in Emergency Department Settings: Validation Using the Emergency Severity Index |
| title_fullStr | A Web-Based Tool for Patient Triage in Emergency Department Settings: Validation Using the Emergency Severity Index |
| title_full_unstemmed | A Web-Based Tool for Patient Triage in Emergency Department Settings: Validation Using the Emergency Severity Index |
| title_short | A Web-Based Tool for Patient Triage in Emergency Department Settings: Validation Using the Emergency Severity Index |
| title_sort | web based tool for patient triage in emergency department settings validation using the emergency severity index |
| url | http://medinform.jmir.org/2015/2/e23/ |
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