Evidence map›Paper›PMID 35777880›Full record

Trial reportBMJ open2022

Differences in emergency nurse triage between a simulated setting and the real world, post hoc analysis of a cluster randomised trial.

Stefan Morreel, Veronique Verhoeven, Hilde Philips, Jasmine Meysman, Ines Homburg, Diana De Graeve, K G Monsieurs

Registry-linked trialOpen access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03793972 (Triaging and Referring in Adjacent General and Emergency Departments), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.5field-weighted citation impact, top 35% of its field
1 · What the graph read from 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.

2 · The registry

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.

NCT03793972 nacompletednot on this map

Triaging and Referring in Adjacent General and Emergency Departments (the TRIAGE-trial): a Cluster Randomised Controlled Trial

TypeinterventionalSponsorUniversiteit AntwerpenRan2019 to 2019Enrolled8,158ConditionsTriageArmsTriage with referral to primary care, Usual care
3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Stefan MorreelDepartment of Family and Population Health, University of Antwerp Faculty of Medicine and Health Sciences, Antwerpen, Belgium Stefan.Morreel@uantwerpen.be.ORCID 0000-0001-6090-2426
Veronique VerhoevenDepartment of Family and Population Health, University of Antwerp Faculty of Medicine and Health Sciences, Antwerpen, Belgium.ORCID 0000-0002-3708-6501
Hilde PhilipsDepartment of Family and Population Health, University of Antwerp Faculty of Medicine and Health Sciences, Antwerpen, Belgium.ORCID 0000-0002-9503-470X
Jasmine MeysmanDepartment of Economics, University of Antwerp, Antwerpen, Belgium.ORCID 0000-0002-3691-4520
Ines HomburgDepartment of Economics, University of Antwerp, Antwerpen, Belgium.ORCID 0000-0003-4186-0974
Diana De GraeveDepartment of Economics, University of Antwerp, Antwerpen, Belgium.ORCID 0000-0002-3098-5352
K G MonsieursEmergency Department, Universitair Ziekenhuis Antwerpen, Edegem, Belgium.ORCID 0000-0002-5068-4848
University of Antwerp · BE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesIn the TRIAGE trial, a cluster randomised trial about diverting emergency department (ED) patients to a general practice cooperative (GPC) using a new extension to the Manchester Triage System, the difference in the proportion of patients assigned to the GPC was striking: 13.3% in the intervention group (patients were encouraged to comply to an ED or GPC assignment, real-world setting) and 24.7% in the control group (the assignment was not communicated, all remained at the ED, simulated setting). In this secondary analysis, we assess the differences in the use of the triage tool between intervention and control group and differences in costs and hospitalisations for patients assigned to the GPC.

settingED of a general hospital and the adjacent GPC.

participants8038 patients (6294 intervention and 1744 control).Primary and secondary outcome measures proportion of patients with triage parameters (reason for encounter, discriminator and urgency category) leading to an assignment to the ED, proportion of patients for which the computer-generated GPC assignment was overruled, motivations for choosing certain parameters, costs (invoices) and hospitalisations.

resultsAn additional 3.1% (p<0.01) of the patients in the intervention group were classified as urgent. Discriminators leading to the ED were registered for an additional 16.2% (p<0.01), mainly because of a perceived need for imaging. Nurses equally chose flow charts leading to the ED (p=0.41) and equally overruled the protocol (p=0.91). In the intervention group, the mean cost for patients assigned to the GPC was €23 (p<0.01) lower and less patients with an assignment to the GPC were hospitalised (1.0% vs 1.6%, p<0.01).

conclusionNurses used a triage tool more risk averse when it was used to divert patients to primary care as compared with a theoretical assignment to primary care. Outcomes from a simulated setting should not be extrapolated to real patients. TRIAL REGISTRATION NUMBER: NCT03793972.

Indexed as

General PracticeTriageFamily PracticeHumansaccident & emergency medicineorganisation of health servicesprimary care

Identifiers

PMID35777880
PMCPMC9252194
OpenAlexW4283771719

What OpenQuestion holds

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LicenceCC BY-NC
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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.