Validation of the Computerized Pediatric Triage Tool, , in the Pediatric Emergency Department of Lenval Children's Hospital in Nice: A Cross-Sectional Observational Study

Overview

Journal Front Pediatr

Specialty Pediatrics

Date 2022 May 20

PMID 35592843

Authors

Antoine Tran

Petri Valo

Camille Rouvier

Emmanuel Dos Ramos

Emma Freyssinet

Emma Baranton

Olivier Haas

Herve Haas

Christian Pradier

Stephanie Gentile

Affiliations

Soon will be listed here.

Abstract

Introduction: A reliable pediatric triage tool is essential for nurses working in pediatric emergency departments to quickly identify children requiring priority care (high-level emergencies) and those who can wait (low-level emergencies). In the absence of a gold standard in France, the objective of our study was to validate our 5-level pediatric triage tool -- against the reference tool: the Pediatric Early Warning Score (PEWS) System.

Materials And Methods: We prospectively included 100,506 children who visited the Pediatric Emergency Department at Lenval Children's Hospital (Nice, France) in 2016 and 2017. The performance of to identify high-level emergencies (severity levels 1 and 2) was evaluated in comparison with a PEWS ≥ 4/9. Data from 2018-19 was used as an independent validation cohort.

Results: agreed with the PEWS score for 84,896 of the patients (84.5%): 15.0% (14.8-15.2) of the patients were over-triaged and 0.5% (0.5-0.6) under-triaged compared with the PEWS score. had a sensitivity of 76.4% (74.6-78.2), a specificity of 84.7% (84.4-84.9), and positive and negative likelihood ratios of 5.0 (4.8-5.1) and 0.3 (0.3-0.3), respectively, for the identification of high-level emergencies. However, the positive likelihood ratios were lower for patients presenting with a medical complaint [4.1 (4.0-4.2) v 10.4 (7.9-13.7 for trauma), and for younger children [1.2 (1.1-1.2) from 0 to 28 days, and 1.9 (1.8-2.0) from 28 days to 3 months].

Conclusion: has a moderate to good validity to triage children in a Pediatric Emergency Department with a tendency to over-triage compared with the PEWS system. Its validity is lower for younger children and for children consulting for a medical complaint.

Citing Articles

Examining the Use of Machine Learning Algorithms to Enhance the Pediatric Triaging Approach.

Aljubran H, Aljubran M, AlAwami A, Aljubran M, Alkhalifah M, Alkhalifah M Open Access Emerg Med. 2025; 17:51-61.

PMID: 39906028 PMC: 11791337. DOI: 10.2147/OAEM.S494280.

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