Premium
Inter‐rater reliability and validity of the M inistry of H ealth of T urkey's mandatory emergency triage instrument
Author(s) -
Erimşah M Emre,
Yaka Elif,
Yilmaz Serkan,
Kama Ahmet,
Pekdemir Murat
Publication year - 2015
Publication title -
emergency medicine australasia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.602
H-Index - 52
eISSN - 1742-6723
pISSN - 1742-6731
DOI - 10.1111/1742-6723.12385
Subject(s) - triage , medicine , emergency department , validity , cohen's kappa , medical emergency , emergency medicine , nursing , psychometrics , clinical psychology , machine learning , computer science
Objectives In 2009, the M inistry of H ealth in T urkey 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 T urkey. Methods 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 vs 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. Results A total of 618 patients were assigned to either red ( n = 126), yellow ( n = 352), or green ( n = 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 ( P < 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). Conclusions This study demonstrates substantial reliability of T urkey's M inistry of H ealth's mandatory three‐level triage instrument. Significant association was also observed between the triage levels and the validity parameters measured in the study.