Inter‐rater reliability and validity of the Ministry of Health of Turkey's mandatory emergency triage instrument. (26th March 2015)

• Record Type: Journal Article
• Authors: Erimşah, M Emre; Yaka, Elif; Yilmaz, Serkan; Kama, Ahmet; Pekdemir, Murat
• Is Part Of: Emergency medicine Australasia. Volume 27:Number 3(2015)
• Page Start: 210
• Page End: 215
• Publication Date: 2015-03-26
• Subjects: Emergency medicine -- Periodicals; Emergency medicine -- Australasia -- Periodicals; 616.025
• DOI: 10.1111/1742-6723.12385
• Languages: English
• ISSNs: 1742-6731

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="emm12385-sec-0001" sec-type="section"> <title>Objectives</title> <p>In 2009, the Ministry of Health in Turkey mandated a three‐level emergency triage scale coded with the colours red, yellow and green in descending order of acuity. This study was conducted to assess the reliability and validity of this mandatory emergency triage instrument in Turkey.</p> </sec> <sec id="emm12385-sec-0002" sec-type="section"> <title>Methods</title> <p>This prospective study was conducted in the ED of an academic hospital with 40 000 presentations per year. The reliability assessment was between triage of a real life patient by an emergency medical technician <italic>vs</italic> the consensus of the investigators based on retrospective medical record review. The inter‐rater agreement method with quadratic weighted kappa analysis was used. The instrument's validity was measured by ED length of stay, admission rates, in‐hospital mortality, ED resource utilisation and lifesaving intervention.</p> </sec> <sec id="emm12385-sec-0003" sec-type="section"> <title>Results</title> <p>A total of 618 patients were assigned to either red (<italic>n</italic> = 126), yellow (<italic>n</italic> = 352), or green (<italic>n</italic> = 140) by acuity level at triage. In this study, the triage scale demonstrated 'substantial' reliability with a quadratic weighted kappa value of 0.725 (95% CI 0.68–0.77). It also suggested validity regarding all the measured surrogate markers, as they were strongly associated with acuity level (<italic>P</italic> < 0.001 for each). Spearman's rank correlation coefficient between triage acuity and total number of used resources was 0.482 (95% CI 0.42–0.54).</p> </sec> <sec id="emm12385-sec-0004" sec-type="section"> <title>Conclusions</title> <p>This study demonstrates substantial reliability of Turkey's Ministry of Health's mandatory three‐level triage instrument. Significant association was also observed between the triage levels and the validity parameters measured in the study.</p> </sec> </abstract>