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The danish regions pediatric triage model has a limited ability to detect both critically ill children as well as children to be sent home without treatment – a study of diagnostic accuracy

Overview of attention for article published in Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, May 2017
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Title
The danish regions pediatric triage model has a limited ability to detect both critically ill children as well as children to be sent home without treatment – a study of diagnostic accuracy
Published in
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, May 2017
DOI 10.1186/s13049-017-0397-6
Pubmed ID
Authors

Lotte Høeg Hansen, Christian Backer Mogensen, Lena Wittenhoff, Helene Skjøt-Arkil

Abstract

The Danish Regions Pediatric Triage model (DRPT) was introduced in 2012 and subsequent implemented in most Danish acute pediatric departments. The aim was to evaluate the validity of DRPT as a screening tool to detect both the most serious acute conditions and the non-serious conditions in the acute referred patients in a pediatric department. The study was prospective observational, with follow-up on all children with acute referral to pediatric department from October to December 2015. The DRPT was evaluated by comparison to a predefined reference standard and to the actual clinical outcomes: critically ill children and children returned to home without any treatment. The sensitivity, specificity, positive predictive value, negative predictive value, accuracy and likelihood for positive and negative test were calculated. Five hundred fifty children were included. The DRPT categorized 7% very urgent, 28% urgent, 29% standard and 36% non-urgent. The DRPT was equal to the reference standard in 31% of the children (CI: 27-35%). DRPT undertriaged 55% of the children (CI: 51-59%) and overtriaged 14% of the children (CI: 11-17%). For the most urgent patients the sensitivity of DRPT was 31% (CI: 20-48%) compared to the reference standard and 20% (CI: 7-41) for critically ill. For children with non-urgent conditions the specificity of DRPT was 66% (CI: 62-71%) compared to the reference standard and 68% (CI: 62-75%) for the children who went home with no treatment. In none of the analyses, the likelihood ratio of the negative test was less than 0.7 and the positive likelihood ratio only reached more than 5 in one of the analyses. This study is the first to evaluate the DRPT triage system. From the very limited validity studies of other well-established triage systems, it is difficult to judge whether the DRPT performs better or worse than the alternatives. The DRPT errs to the undertriage side. If the sensitivity is low, a number of the sickest children are undetected and this is a matter of concern. The DRPT is a triage tool with limited ability to detect the critically ill children as well as the children who can be returned to home without any treatment. Not relevant.

X Demographics

X Demographics

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 31 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 31 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 7 23%
Other 4 13%
Professor 4 13%
Researcher 4 13%
Student > Doctoral Student 3 10%
Other 5 16%
Unknown 4 13%
Readers by discipline Count As %
Medicine and Dentistry 13 42%
Nursing and Health Professions 10 32%
Social Sciences 2 6%
Unknown 6 19%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 23 June 2017.
All research outputs
#14,349,470
of 22,977,819 outputs
Outputs from Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
#919
of 1,263 outputs
Outputs of similar age
#176,696
of 316,100 outputs
Outputs of similar age from Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
#21
of 27 outputs
Altmetric has tracked 22,977,819 research outputs across all sources so far. This one is in the 35th percentile – i.e., 35% of other outputs scored the same or lower than it.
So far Altmetric has tracked 1,263 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 10.2. This one is in the 22nd percentile – i.e., 22% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 316,100 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 41st percentile – i.e., 41% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 27 others from the same source and published within six weeks on either side of this one. This one is in the 18th percentile – i.e., 18% of its contemporaries scored the same or lower than it.