OBJECTIVE: To improve the Manchester Triage System (MTS) in paediatric emergency care. METHODS: The authors performed a prospective observational study at the emergency departments of a university and teaching hospital in The Netherlands and included children attending in 2007 and 2008. The authors developed and implemented specific age-dependent modifications for the MTS, based on patient groups where the system's performance was low. Nurses applied the modified system in 11,481 (84%) patients. The reference standard for urgency defined five levels based on a combination of vital signs at presentation, potentially life-threatening conditions, diagnostic resources, therapeutic interventions and follow-up. The reference standard for urgency was previously defined and available in 11,260/11,481 (96%) patients. RESULTS: Compared with the original MTS specificity improved from 79% (95% CI 79% to 80%) to 87% (95% CI 86% to 87%) while sensitivity remained similar ((63%, 95% CI 59% to 66%) vs (64%, 95% CI 60% to 68%)). The diagnostic OR increased (4.1 vs 11). CONCLUSIONS: Modifications of the MTS for paediatric emergency care resulted in an improved specificity while sensitivity remained unchanged. Further research should focus on the improvement of sensitivity.
OBJECTIVE: To improve the Manchester Triage System (MTS) in paediatric emergency care. METHODS: The authors performed a prospective observational study at the emergency departments of a university and teaching hospital in The Netherlands and included children attending in 2007 and 2008. The authors developed and implemented specific age-dependent modifications for the MTS, based on patient groups where the system's performance was low. Nurses applied the modified system in 11,481 (84%) patients. The reference standard for urgency defined five levels based on a combination of vital signs at presentation, potentially life-threatening conditions, diagnostic resources, therapeutic interventions and follow-up. The reference standard for urgency was previously defined and available in 11,260/11,481 (96%) patients. RESULTS: Compared with the original MTS specificity improved from 79% (95% CI 79% to 80%) to 87% (95% CI 86% to 87%) while sensitivity remained similar ((63%, 95% CI 59% to 66%) vs (64%, 95% CI 60% to 68%)). The diagnostic OR increased (4.1 vs 11). CONCLUSIONS: Modifications of the MTS for paediatric emergency care resulted in an improved specificity while sensitivity remained unchanged. Further research should focus on the improvement of sensitivity.
Authors: Nienke Seiger; Mirjam van Veen; Helena Almeida; Ewout W Steyerberg; Alfred H J van Meurs; Rita Carneiro; Claudio F Alves; Ian Maconochie; Johan van der Lei; Henriëtte A Moll Journal: PLoS One Date: 2014-01-15 Impact factor: 3.240
Authors: Joany M Zachariasse; Nienke Seiger; Pleunie P M Rood; Claudio F Alves; Paulo Freitas; Frank J Smit; Gert R Roukema; Henriëtte A Moll Journal: PLoS One Date: 2017-02-02 Impact factor: 3.240
Authors: Laura C Blomaard; Corianne Speksnijder; Jacinta A Lucke; Jelle de Gelder; Sander Anten; Stephanie C E Schuit; Ewout W Steyerberg; Jacobijn Gussekloo; Bas de Groot; Simon P Mooijaart Journal: J Am Geriatr Soc Date: 2020-04-04 Impact factor: 5.562