ArticleJournal of the American College of Surgeons2016
Cost-Effectiveness of Field Trauma Triage among Injured Adults Served by Emergency Medical Services.
Article in Journal of the American College of Surgeons, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 44 citations in OpenAlex.
- A Consensus-Based Criterion Standard for the Requirement of a Trauma Team.World journal of surgery · 2018Guideline
- Mobile triage units for abdominal trauma in sub-Saharan Africa: current evidence, implementation barriers, and strategies for scale-up.Annals of medicine and surgery (2012) · 2026Review
- Triage Accuracy and the 2015 Field Trauma Triage Criteria Update.JAMA network open · 2026Article
- Article
- 'Endless variation on a theme': a document analysis of international and UK major trauma triage tools.British paramedic journal · 2024Article
- Major Trauma Triage Tool Study (MATTS) expert consensus-derived injury assessment tool.British paramedic journal · 2024Article
- The predictive value of serum lactate to forecast injury severity in trauma-patients increases taking age into account.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Article
- The accuracy of prehospital triage decisions in English trauma networks - a case-cohort study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2024Article
- ISS alone, is not sufficient to correctly assign patients post hoc to trauma team requirement.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Article
- An economic evaluation of triage tools for patients with suspected severe injuries in England.BMC emergency medicine · 2022Article
- Performance of pre-hospital evaluations in ruling out invasive chest stab wounds.Scandinavian journal of trauma, resuscitation and emergency medicine · 2020Observational
- DRG-Oriented Mathematical Calculation Model and Method of Integrated Medical Service Cost.Computational and mathematical methods in medicine · 2020Article
- Crash Telemetry-Based Injury Severity Prediction is Equivalent to or Out-Performs Field Protocols in Triage of Planar Vehicle Collisions.Prehospital and disaster medicine · 2019Article
- Article
- [Optimization of criteria for activation of trauma teams : Avoidance of overtriage and undertriage].Der Unfallchirurg · 2018Article
- Undertriage of major trauma patients at a university hospital: a retrospective cohort study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2018Article
- Comparative Effectiveness of Initial Treatment at Trauma Center vs Neurosurgery-Capable Non-Trauma Center for Severe, Isolated Head Injury.Journal of the American College of Surgeons · 2018Article
Corrections and comments
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Authors and funding
14 authors at 8 institutions in 1 country.
Funding
Abstract
backgroundThe American College of Surgeons Committee on Trauma sets national targets for the accuracy of field trauma triage at ≥95% sensitivity and ≥65% specificity, yet the cost-effectiveness of realizing these goals is unknown. We evaluated the cost-effectiveness of current field trauma triage practices compared with triage strategies consistent with the national targets. STUDY
designThis was a cost-effectiveness analysis using data from 79,937 injured adults transported by 48 emergency medical services agencies to 105 trauma and nontrauma hospitals in 6 regions of the western United States from 2006 through 2008. Incremental differences in survival, quality-adjusted life years (QALYs), costs, and the incremental cost-effectiveness ratio (costs per QALY gained) were estimated for each triage strategy during a 1-year and lifetime horizon using a decision analytic Markov model. We considered an incremental cost-effectiveness ratio threshold of <$100,000 to be cost-effective.
resultsFor these 6 regions, a high-sensitivity triage strategy consistent with national trauma policy (sensitivity 98.6%, specificity 17.1%) would cost $1,317,333 per QALY gained, and current triage practices (sensitivity 87.2%, specificity 64.0%) cost $88,000 per QALY gained, compared with a moderate sensitivity strategy (sensitivity 71.2%, specificity 66.5%). Refining emergency medical services transport patterns by triage status improved cost-effectiveness. At the trauma-system level, a high-sensitivity triage strategy would save 3.7 additional lives per year at a 1-year cost of $8.78 million, and a moderate sensitivity approach would cost 5.2 additional lives and save $781,616 each year.
conclusionsA high-sensitivity approach to field triage consistent with national trauma policy is not cost-effective. The most cost-effective approach to field triage appears closely tied to triage specificity and adherence to triage-based emergency medical services transport practices.
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