ArticleBMJ open2017
Appropriateness of cases presenting in the emergency department following ambulance service secondary telephone triage: a retrospective cohort study.
Article in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The Economic Impact of Community Paramedics Within Emergency Medical Services: A Systematic Review.Applied health economics and health policy · 2024Pooled it
- Geriatrician telephone support for emergency medical dispatchers: safe alternatives for older patients at high risk of short-term emergency department visits.European geriatric medicine · 2026Article
- Ambulance Use Appropriateness: Emergency Medical Service Technicians' and Triage Nurses' Assessments and Patients' Perceptions.Nursing reports (Pavia, Italy) · 2025Article
- Article
- Article
- Paramedic Education to Support the Use of Low-Acuity Care Pathways: A Scoping Review Protocol.Nursing reports (Pavia, Italy) · 2023Article
- Telephone triage service use is associated with better outcomes among patients with cerebrovascular diseases: a propensity score analysis using population-based data.Frontiers in public health · 2023Article
- Emergency calls concerning older patients: Are the appropriate questions asked?Geriatrics & gerontology international · 2023Observational
- Paramedic management of back pain: a scoping review.BMC emergency medicine · 2022Article
- Linking Ambulance Records with Hospital and Death Index Data to Evaluate Patient Outcomes.International journal of general medicine · 2022Article
- Telephone Triage for Emergency Patients Reduces Unnecessary Ambulance Use: A Propensity Score Analysis With Population-Based Data in Osaka City, Japan.Frontiers in public health · 2022Observational
- A Mobile App for Self-Triage for Pediatric Emergency Patients in Japan: 4 Year Descriptive Epidemiological Study.JMIR pediatrics and parenting · 2021Article
- Article
- Secondary Overtriage of Trauma Patients to a Central Hospital in Malawi.World journal of surgery · 2020Article
- Differences between cases admitted to hospital and discharged from the emergency department after emergency medical services transport.BMJ open · 2019Observational
- Article
- Patient and case characteristics associated with 'no paramedic treatment' for low-acuity cases referred for emergency ambulance dispatch following a secondary telephone triage: a retrospective cohort study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2018Article
- Characteristics and outcome of patients triaged by telephone and transported by ambulance: a population-based study in Osaka, Japan.Acute medicine & surgeryArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo investigate the appropriateness of cases presenting to the emergency department (ED) following ambulance-based secondary telephone triage.
designA pragmatic retrospective cohort analysis of all the planned and unplanned ED presentations within 48 hours of a secondary telephone triage.
settingThe secondary telephone triage service, called the Referral Service, and the hospitals were located in metropolitan Melbourne, Australia and operated 24 hours a day, servicing 4.25 million people. The Referral Service provides an in-depth secondary triage of cases classified as low acuity when calling the Australian emergency telephone number. POPULATION: Cases triaged by the Referral Service between September 2009 and June 2012 were linked to ED and hospital admission records (N=44,523). Planned ED presentations were cases referred to the ED following the secondary triage, unplanned ED presentations were cases that presented despite being referred to alternative care pathways.
main outcome measuresAppropriateness was measured using an ED suitability definition and hospital admission rates. These were compared with mean population data which consisted of all of the ED presentations for the state (termed the 'average Victorian ED presentation').
resultsPlanned ED presentations were more likely to be ED suitable than unplanned ED presentations (OR 1.62; 95% CI 1.5 to 1.7; p<0.001) and the average Victorian ED presentation (OR 1.85; 95% CI 1.01 to 3.4; p=0.046). They were also more likely to be admitted to the hospital than the unplanned ED presentation (OR 1.5; 95% CI 1.4 to 1.6; p<0.001) and the average Victorian ED presentation (OR 2.3, 95% CI 2.24 to 2.33; p<0.001). Just under 15% of cases diverted away from the emergency care pathways presented in the ED (unplanned ED attendances), and 9.5% of all the alternative care pathway cases were classified as ED suitable and 6.5% were admitted to hospital.
conclusionsSecondary telephone triage was able to appropriately identify many ED suitable cases, and while most cases referred to alternative care pathways did not present in the ED. Further research is required to establish that these were not inappropriately triaged away from the emergency care pathways.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.