ArticleJournal of clinical medicine2020
Physicians' Disease Severity Ratings are Non-Inferior to the Emergency Severity Index.
Article in Journal of clinical medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Updating the International Early Warning Score with frailty and comparing to gestalt for prediction of 3-day critical illness and mortality in emergency department patients.Internal and emergency medicine · 2026Article
- Reducing Mis-triage in Emergency Departments (RemEDy): Protocol for Improving Triage Accuracy Through Real-time Evaluation and Artificial Intelligence.JMIR research protocols · 2026Article
- Clinical Gestalt to Predict Bacterial Infection and Mortality in Emergency Department Patients: A Prospective Observational Study.Journal of general internal medicine · 2026Observational
- Comparing the utility of clinical risk scores and integrated clinical judgement in patients with suspected acute coronary syndrome.European heart journal. Acute cardiovascular care · 2023Article
- A fast emergency department triage score based on mobility, mental status and oxygen saturation compared with the emergency severity index: a prospective cohort study.QJM : monthly journal of the Association of Physicians · 2023Observational
- The Value of the First Clinical Impression as Assessed by 18 Observations in Patients Presenting to the Emergency Department.Journal of clinical medicine · 2023Article
- Validation of a Simple Score for Mortality Prediction in a Cohort of Unselected Emergency Patients.International journal of clinical practice · 2022Article
- Association of Frailty with Adverse Outcomes in Patients with Suspected COVID-19 Infection.Journal of clinical medicine · 2021Article
- Disposition Decision Support by Laboratory Based Outcome Prediction.Journal of clinical medicine · 2021Article
- COVID-19 Triage and Test Center: Safety, Feasibility, and Outcomes of Low-Threshold Testing.Journal of clinical medicine · 2020Article
- Nontraumatic Headache in Adult Emergency Patients: Prevalence, Etiologies, and Radiological Findings.Journal of clinical medicine · 2020Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Our objective was to compare informal physicians' disease severity ratings (PDSR) at presentation with the well-established Emergency Severity Index (ESI) in order to test for non-inferiority of the discriminatory ability regarding hospitalization, intensive care, and mortality. We made a prospective observational study with consecutive enrollment. At presentation, the PDSR and subsequently Emergency Severity Index (ESI) levels were recorded. The primary outcome was the non-inferiority of the discriminatory ability (PDSR versus ESI) regarding hospitalization, intensive care, and mortality. The secondary outcomes were the reliability, the predictive validity, and the safety of PDSR. We included 6859 patients. The median age was 51 years (interquartile range (IQR) = 33 to 72 years); 51.4% were males. There were 159 non-survivors (2.4%) at the 30 day follow-up. The PDSR's discriminatory ability was non-inferior to the ESI's discriminatory ability. The safety assessment showed mortality of <0.5% in low-acuity patients in both tools. The predictive validity increased by 3.5 to 7 times if adding high-acuity PDSR to ESI in all categories with mortality of >1%. Our data showed the non-inferiority of PDSR compared with ESI regarding discriminatory ability, a moderate reliability, and an acceptable safety of both tools.
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