ArticleEmergency medicine international2026
Interrater Agreement Between Paramedic CTAS Scores and an Electronic CTAS Tool: A Retrospective Study Across Eastern Ontario.
Article in Emergency medicine international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objectives: To assess interrater agreement between the Canadian triage and acuity scale (CTAS) scores assigned by paramedics and those assigned by a paramedic rater using an electronic smartphone application, aiming to identify training gaps and potential patient safety risks associated with CTAS scoring in Canadian hospital emergency departments (CEDs). Methods: A retrospective analysis was conducted using 192,326 CTAS-level call data collected from electronic patient care records of nine paramedic services. Data were entered into an electronic CTAS smartphone app. The calls were categorized based on contact level and the sample size. Minitab software and VassarStats were used to calculate the quadratic-weighted Cohen's kappa ( Results: A retrospective analysis of 1651 paramedic call reports from across Eastern Ontario compared paramedic-assigned CTAS scores with those generated using an eCTAS smartphone tool. Overall agreement between raters was substantial ( Conclusions: This study found near-perfect agreement between paramedic documentation and the paramedic smartphone application for CTAS-1 in acute patients, with moderate agreement for other levels. Further studies should include multiple raters to better understand the implications of using a smartphone application.
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