title: Triage of children with headache at the ED: a guideline implementation study.
abstract: We present a multicenter validation of a modified Manchester Triage System (MTS) flowchart for pediatric patients who present with headache to the emergency department. A prospective observational study was conducted across 5 European pediatric emergency departments. The standard MTS headache flowchart and a modified MTS headache flowchart were tested in the participating centers, and results were compared with triage categories identified by either the physician at the end of the clinical examination or the reference classification matrix (RCM). Fifty-three patients were enrolled in the preimplementation phase and 112 in the postimplementation phase. When compared with physician's triage and RCM, the modified MTS flowchart demonstrated good sensitivity (79% and 70%, respectively), specificity (77% and 76%, respectively), and a high positive likelihood ratio (9.14 and 16.75, respectively) for the identification of low-risk children.
  
  
  CONCLUSIONS
  Our modified headache flowchart is safe and reliable in pediatric emergency settings, especially for lower classes of urgency.
authors: Department of Pediatrics, Piemonte Orientale University, Novara, Italy.
authors: Veronica
authors: V
authors: Balossini
authors: Anna
authors: A
authors: Zanin
authors: Corinne
authors: C
authors: Alberti
authors: Yonathan
authors: Y
authors: Freund
authors: Marion
authors: M
authors: Decobert
authors: Antonella
authors: A
authors: Tarantino
authors: Maria
authors: M
authors: La Rocca
authors: Laurence
authors: L
authors: Lacroix
authors: Daniele
authors: D
authors: Spiri
authors: Emilie
authors: E
authors: Lejay
authors: Priscilla
authors: P
authors: Armoogum
authors: Chantal
authors: C
authors: Wood
authors: Alain
authors: A
authors: Gervaix
authors: Gian Vincenzo
authors: GV
authors: Zuccotti
authors: Giorgio
authors: G
authors: Perilongo
authors: Gianni
authors: G
authors: Bona
authors: Jean-Christophe
authors: JC
authors: Mercier
authors: Luigi
authors: L
authors: Titomanlio
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital; D005260:Female; D019983:Guideline Adherence; D006261:Headache / Q000145:classification* / Q000209:etiology; D006801:Humans; D008297:Male; D011446:Prospective Studies; D014218:Triage / Q000379:methods*