Validation of dutch obstetric telephone triage system:A prospective validation study
Objective and Purpose: A triage system that prioritizes care according to medical urgency has a favorable effect on safety and efficiency of emergency care. The Dutch obstetric telephone triage system is comparable to physical triage systems. It consists of five urgency levels: resuscitation and life threatening (U1), emergency (U2), urgent (U3), non-urgent (U4) and self-care advice (U5). The purpose of this study was to determine the diagnostic and external validity of the Dutch obstetric telephone triage system in obstetric emergency care. Patients and Methods: The validity of the Dutch obst... Mehr ...
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Dokumenttyp: | Artikel |
Erscheinungsdatum: | 2021 |
Reihe/Periodikum: | Engeltjes , B , Van Dijk , C , Rosman , A , Rijke , R , Scheele , F & Wouters , E 2021 , ' Validation of dutch obstetric telephone triage system : A prospective validation study ' , Risk management and healthcare policy , vol. 14 , pp. 1907-1915 . https://doi.org/10.2147/RMHP.S306390 |
Schlagwörter: | Diagnostic validity / External validity / Obstetric emergency care / Sensitivity / Telephone triage / Under-triage / /dk/atira/pure/sustainabledevelopmentgoals/good_health_and_well_being / name=SDG 3 - Good Health and Well-being |
Sprache: | Englisch |
Permalink: | https://search.fid-benelux.de/Record/base-27075596 |
Datenquelle: | BASE; Originalkatalog |
Powered By: | BASE |
Link(s) : | https://research.vu.nl/en/publications/1630ded9-4249-44c2-8df2-4757bca1c6c8 |
Objective and Purpose: A triage system that prioritizes care according to medical urgency has a favorable effect on safety and efficiency of emergency care. The Dutch obstetric telephone triage system is comparable to physical triage systems. It consists of five urgency levels: resuscitation and life threatening (U1), emergency (U2), urgent (U3), non-urgent (U4) and self-care advice (U5). The purpose of this study was to determine the diagnostic and external validity of the Dutch obstetric telephone triage system in obstetric emergency care. Patients and Methods: The validity of the Dutch obstetric telephone triage system was studied in a prospective observational study in four hospitals. Diagnostic validity of usual care was determined by comparing the assigned urgency level of the Dutch obstetric telephone triage system with a reference standard. This reference standard was obtained by face-to-face clinical assessment in hospital following telephone triage. Clinical follow-up after assessment was also recorded. For statistical analyses, urgency levels were dichotomized into high urgency (U1, U2) and intermediate urgency (U3, U4). Self-care advice (U5) could not be studied because these patients were not referred to hospital. Results: In total, 983 cases (U1-U4) across the four hospitals were included, 625 (64%) cases were categorized as high urgency and 358 (36%) as intermediate urgency. The Dutch obstetric telephone triage system’s urgency level agreed with the reference standard in 53% (n=525; 95% CI 50–57%). According to the reference standard the Dutch obstetric telephone triage system had undertriage in 16% (n=160) and overtriage in 30% (n=298) of the cases. Sensitivity for high urgency was 76% (95% CI 72–80), specificity 49% (95% CI 44–53). Positive predictive value and negative predictive value were 60% (95% CI 56–63) and 67% (95% CI 62–72), respectively. After clinical assessment, urgent care was needed in 8.7% (n=31) of the intermediate-urgency cases, none of these cases were life threatening ...