Observational studyScandinavian journal of trauma, resuscitation and emergency medicine2020
Pre-hospital triage performance and emergency medical services nurse's field assessment in an unselected patient population attended to by the emergency medical services: a prospective observational study.
Observational study in Scandinavian journal of trauma, resuscitation and emergency medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 42 citations in OpenAlex.
- Review article: Use of prehospital early warning scores to predict short-term mortality: A systematic review.Emergency medicine Australasia : EMA · 2025Pooled it
- Pooled it
- Trauma handover practices between ambulance clinicians, emergency department staff and trauma teams: scoping review.BMC emergency medicine · 2026Article
- Evaluating the real-world utility of four physiological scores for prehospital interventions in resource-limited EMS systems: a population-based study of 15,720 cases.BMC health services research · 2026Article
- Frequent users of the ambulance service in a Swedish region: a retrospective cohort study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Article
- Occupational Stress in Pre-Hospital Emergency Care: A Review on Influencing Factors and Consequences and Management: A Systematic Review.Advanced biomedical research · 2026Review
- Effectiveness of Five-Level Prehospital Taiwan Triage and Acuity Scale (TTAS-PH) in Emergency Medical Services for Patient Outcome Prediction: A Retrospective Cohort Study.International journal of general medicine · 2026Article
- Machine learning to improve predictive performance of prehospital early warning scores.Scientific reports · 2025Article
- Uncovering nonlinear patterns in time-sensitive prehospital breathing emergencies: an exploratory machine learning study.BMC medical informatics and decision making · 2025Observational
- Fast track to stroke unit for patients not eligible for acute intervention, a case-control register study on 1066 patients.Scientific reports · 2023Article
- Crossover design in triage education: the effectiveness of simulated interactive vs. routine training on student nurses' performance in a disaster situation.BMC research notes · 2023Article
- Age in addition to RETTS triage priority substantially improves 3-day mortality prediction in emergency department patients: a multi-center cohort study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2023Observational
- Prehospital Early Warning Scores to Predict Mortality in Patients Using Ambulances.JAMA network open · 2023Article
- The accuracy of the National Early Warning Score 2 in predicting early death in prehospital and emergency department settings: a systematic review and meta-analysis.Annals of translational medicine · 2023Article
- A longitudinal, retrospective registry-based validation study of RETTS©, the Swedish adult ED context version.Scandinavian journal of trauma, resuscitation and emergency medicine · 2022Article
- Pathways to the emergency department - a national, cross-sectional study in Sweden.BMC emergency medicine · 2022Review
- Predictors of short- and long-term mortality in critically ill, older adults admitted to the emergency department: an observational study.BMC emergency medicine · 2022Observational
- A registry-based observational study comparing emergency calls assessed by emergency medical dispatchers with and without support by registered nurses.Scandinavian journal of trauma, resuscitation and emergency medicine · 2022Observational
- Pre-hospital suPAR, lactate and CRP measurements for decision-making: a prospective, observational study of patients presenting non-specific complaints.Scandinavian journal of trauma, resuscitation and emergency medicine · 2021Observational
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn Sweden, the rapid emergency triage and treatment system (RETTS-A) is used in the pre-hospital setting. With RETTS-A, patients triaged to the lowest level could safely be referred to a lower level of care. The national early warning score (NEWS) has also shown promising results internationally. However, a knowledge gap in optimal triage in the pre-hospital setting persists. This study aimed to evaluate RETTS-A performance, compare RETTS-A with NEWS and NEWS 2, and evaluate the emergency medical service (EMS) nurse's field assessment with the physician's final hospital diagnosis.
methodsA prospective, observational study including patients (≥16 years old) transported to hospital by the Gothenburg EMS in 2016. Three comparisons were made: 1) Combined RETTS-A levels orange and red (high acuity) compared to a predefined reference emergency, 2) RETTS-A high acuity compared to NEWS and NEWS 2 score ≥ 5, and 3) Classification of pre-hospital nurse's field assessment compared to hospital physician's diagnosis. Outcomes of the time-sensitive conditions, mortality and hospitalisation were examined. The statistical tests included Mann-Whitney U test and Fisher's exact test, and several binary classification tests were determined.
resultsOverall, 4465 patients were included (median age 69 years; 52% women). High acuity RETTS-A triage showed a sensitivity of 81% in prediction of the reference patient with a specificity of 64%. Sensitivity in detecting a time-sensitive condition was highest with RETTS-A (73%), compared with NEWS (37%) and NEWS 2 (35%), and specificity was highest with NEWS 2 (83%) when compared with RETTS-A (54%). The negative predictive value was higher in RETTS-A (94%) compared to NEWS (91%) and NEWS 2 (92%). Eleven per cent of the final diagnoses were classified as time-sensitive while the nurse's field assessment was appropriate in 84% of these cases.
conclusionsIn the pre-hospital triage of EMS patients, RETTS-A showed sensitivity that was twice as high as that of both NEWS and NEWS 2 in detecting time-sensitive conditions, at the expense of lower specificity. However, the proportion of correctly classified low risk triaged patients (green/yellow) was higher in RETTS-A. The nurse's field assessment of time-sensitive conditions was appropriate in the majority of cases.
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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.