Validity of the computerized version of the pediatric triage system CLARIPED for emergency care

Detalhes bibliográficos
Autor(a) principal: Traldi,Paula de Carmago
Data de Publicação: 2022
Outros Autores: Magalhães-Barbosa,Maria Clara de, Raymundo,Carlos Eduardo, Cunha,Antonio José Ledo Alves da, Prata-Barbosa,Arnaldo
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Jornal de Pediatria (Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0021-75572022000400369
Resumo: Abstract Objective: To evaluate the validity of the computerized version of the pediatric triage system CLARIPED. Methods: Prospective, observational study in a tertiary emergency department (ED) from Jan-2018 to Jan-2019. A convenience sample of patients aged 0-18 years who had computerized triage and outcome variables registered. Construct validity was assessed through the association between urgency levels and patient outcomes. Sensitivity, specificity, positive and negative predictive values (PPVand NPV), undertriage, and overtriage rates were assessed. Results: 19,122 of 38,321 visits were analyzed. The urgency levels were: RED (emergency) 0.02%, ORANGE (high urgency) 3.21%, YELLOW (urgency) 35.69%, GREEN (low urgency) 58.46%, and BLUE (no urgency) 2.62%. The following outcomes increased according to the increase in the level of urgency: hospital admission (0.4%, 0.6%, 3.1%, 11.9% and 25%), stay in the ED observation room (2.8%, 4.7%, 15.9%, 40.4%, 50%), ≥ 2 diagnostic or therapeutic resources (7.8%, 16.5%, 33.7%, 60.6%, 75%), and ED length of stay in minutes (18, 24, 67,120, 260). The odds of using ≥ 2 resources or being hospitalized were significantly greater in the most urgent patients (Red, Orange, and Yellow) compared to the least urgent (Green and Blue): OR 7.88 (95%CI: 5.35-11.6) and OR 2.85 (95%CI: 2.63-3.09), respectively. The sensitivity to identify urgency was 0.82 (95%CI: 0.77-0.85); specificity, 0.62 (95%CI: 0.61-0.6; NPV, 0.99 (95%CI: 0.99-1.00); overtriage rate, 4.28% and undertriage, 18.41%. Conclusion: The computerized version of CLARIPED is a valid and safe pediatric triage system, with a significant correlation with clinical outcomes, good sensitivity, and low undertriage rate.
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spelling Validity of the computerized version of the pediatric triage system CLARIPED for emergency careEmergency carePediatricTriageValidityLow and middle-income countriesAbstract Objective: To evaluate the validity of the computerized version of the pediatric triage system CLARIPED. Methods: Prospective, observational study in a tertiary emergency department (ED) from Jan-2018 to Jan-2019. A convenience sample of patients aged 0-18 years who had computerized triage and outcome variables registered. Construct validity was assessed through the association between urgency levels and patient outcomes. Sensitivity, specificity, positive and negative predictive values (PPVand NPV), undertriage, and overtriage rates were assessed. Results: 19,122 of 38,321 visits were analyzed. The urgency levels were: RED (emergency) 0.02%, ORANGE (high urgency) 3.21%, YELLOW (urgency) 35.69%, GREEN (low urgency) 58.46%, and BLUE (no urgency) 2.62%. The following outcomes increased according to the increase in the level of urgency: hospital admission (0.4%, 0.6%, 3.1%, 11.9% and 25%), stay in the ED observation room (2.8%, 4.7%, 15.9%, 40.4%, 50%), ≥ 2 diagnostic or therapeutic resources (7.8%, 16.5%, 33.7%, 60.6%, 75%), and ED length of stay in minutes (18, 24, 67,120, 260). The odds of using ≥ 2 resources or being hospitalized were significantly greater in the most urgent patients (Red, Orange, and Yellow) compared to the least urgent (Green and Blue): OR 7.88 (95%CI: 5.35-11.6) and OR 2.85 (95%CI: 2.63-3.09), respectively. The sensitivity to identify urgency was 0.82 (95%CI: 0.77-0.85); specificity, 0.62 (95%CI: 0.61-0.6; NPV, 0.99 (95%CI: 0.99-1.00); overtriage rate, 4.28% and undertriage, 18.41%. Conclusion: The computerized version of CLARIPED is a valid and safe pediatric triage system, with a significant correlation with clinical outcomes, good sensitivity, and low undertriage rate.Sociedade Brasileira de Pediatria2022-07-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0021-75572022000400369Jornal de Pediatria v.98 n.4 2022reponame:Jornal de Pediatria (Online)instname:Sociedade Brasileira de Pediatria (SBP)instacron:SBPE10.1016/j.jped.2021.08.004info:eu-repo/semantics/openAccessTraldi,Paula de CarmagoMagalhães-Barbosa,Maria Clara deRaymundo,Carlos EduardoCunha,Antonio José Ledo Alves daPrata-Barbosa,Arnaldoeng2022-07-20T00:00:00Zoai:scielo:S0021-75572022000400369Revistahttp://www.jped.com.br/https://old.scielo.br/oai/scielo-oai.php||jped@jped.com.br1678-47820021-7557opendoar:2022-07-20T00:00Jornal de Pediatria (Online) - Sociedade Brasileira de Pediatria (SBP)false
dc.title.none.fl_str_mv Validity of the computerized version of the pediatric triage system CLARIPED for emergency care
title Validity of the computerized version of the pediatric triage system CLARIPED for emergency care
spellingShingle Validity of the computerized version of the pediatric triage system CLARIPED for emergency care
Traldi,Paula de Carmago
Emergency care
Pediatric
Triage
Validity
Low and middle-income countries
title_short Validity of the computerized version of the pediatric triage system CLARIPED for emergency care
title_full Validity of the computerized version of the pediatric triage system CLARIPED for emergency care
title_fullStr Validity of the computerized version of the pediatric triage system CLARIPED for emergency care
title_full_unstemmed Validity of the computerized version of the pediatric triage system CLARIPED for emergency care
title_sort Validity of the computerized version of the pediatric triage system CLARIPED for emergency care
author Traldi,Paula de Carmago
author_facet Traldi,Paula de Carmago
Magalhães-Barbosa,Maria Clara de
Raymundo,Carlos Eduardo
Cunha,Antonio José Ledo Alves da
Prata-Barbosa,Arnaldo
author_role author
author2 Magalhães-Barbosa,Maria Clara de
Raymundo,Carlos Eduardo
Cunha,Antonio José Ledo Alves da
Prata-Barbosa,Arnaldo
author2_role author
author
author
author
dc.contributor.author.fl_str_mv Traldi,Paula de Carmago
Magalhães-Barbosa,Maria Clara de
Raymundo,Carlos Eduardo
Cunha,Antonio José Ledo Alves da
Prata-Barbosa,Arnaldo
dc.subject.por.fl_str_mv Emergency care
Pediatric
Triage
Validity
Low and middle-income countries
topic Emergency care
Pediatric
Triage
Validity
Low and middle-income countries
description Abstract Objective: To evaluate the validity of the computerized version of the pediatric triage system CLARIPED. Methods: Prospective, observational study in a tertiary emergency department (ED) from Jan-2018 to Jan-2019. A convenience sample of patients aged 0-18 years who had computerized triage and outcome variables registered. Construct validity was assessed through the association between urgency levels and patient outcomes. Sensitivity, specificity, positive and negative predictive values (PPVand NPV), undertriage, and overtriage rates were assessed. Results: 19,122 of 38,321 visits were analyzed. The urgency levels were: RED (emergency) 0.02%, ORANGE (high urgency) 3.21%, YELLOW (urgency) 35.69%, GREEN (low urgency) 58.46%, and BLUE (no urgency) 2.62%. The following outcomes increased according to the increase in the level of urgency: hospital admission (0.4%, 0.6%, 3.1%, 11.9% and 25%), stay in the ED observation room (2.8%, 4.7%, 15.9%, 40.4%, 50%), ≥ 2 diagnostic or therapeutic resources (7.8%, 16.5%, 33.7%, 60.6%, 75%), and ED length of stay in minutes (18, 24, 67,120, 260). The odds of using ≥ 2 resources or being hospitalized were significantly greater in the most urgent patients (Red, Orange, and Yellow) compared to the least urgent (Green and Blue): OR 7.88 (95%CI: 5.35-11.6) and OR 2.85 (95%CI: 2.63-3.09), respectively. The sensitivity to identify urgency was 0.82 (95%CI: 0.77-0.85); specificity, 0.62 (95%CI: 0.61-0.6; NPV, 0.99 (95%CI: 0.99-1.00); overtriage rate, 4.28% and undertriage, 18.41%. Conclusion: The computerized version of CLARIPED is a valid and safe pediatric triage system, with a significant correlation with clinical outcomes, good sensitivity, and low undertriage rate.
publishDate 2022
dc.date.none.fl_str_mv 2022-07-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
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dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0021-75572022000400369
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dc.language.iso.fl_str_mv eng
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dc.relation.none.fl_str_mv 10.1016/j.jped.2021.08.004
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
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dc.publisher.none.fl_str_mv Sociedade Brasileira de Pediatria
publisher.none.fl_str_mv Sociedade Brasileira de Pediatria
dc.source.none.fl_str_mv Jornal de Pediatria v.98 n.4 2022
reponame:Jornal de Pediatria (Online)
instname:Sociedade Brasileira de Pediatria (SBP)
instacron:SBPE
instname_str Sociedade Brasileira de Pediatria (SBP)
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reponame_str Jornal de Pediatria (Online)
collection Jornal de Pediatria (Online)
repository.name.fl_str_mv Jornal de Pediatria (Online) - Sociedade Brasileira de Pediatria (SBP)
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