Towards patient self-triage in the ophthalmic emergency department: sensitivity and specificity of a self-triage instrument.
OBJECTIVE
Trained ophthalmic triage staff may not constantly be available in the emergency department of a specialized ophthalmic hospital, particularly at night. To support the current triage process, the aim of this study was to develop an ophthalmic instrument of patient self-triage (ISET).


METHODS
A preliminary ISET, in the form of a pen-and-paper questionnaire, was refined and validated in a two-step procedure. In a first explorative step, we compared the results of the ISET with the results of the regular triage process during the day, that is, triage by a trained triage assistant in a specialized ophthalmic hospital. As several patients needed guidance completing the questionnaire, the ISET was subsequently refined. The second step was to test the validity of the refined ISET by again comparing the outcome of this triage with that of the triage assistant in the emergency department.


RESULTS
The first explorative step involved 279 patients and the final validation step 298. During the validation step, sensitivity of the ISET was 94.3% and specificity 76.4%.


CONCLUSIONS
The results show that the ISET is a sensitive and specific instrument for ophthalmic triage compared with a trained ophthalmic triage assistant.
Rotterdam Ophthalmic Institute, Rotterdam, The Netherlands; Department of Psychiatry, Section of Medical Psychology & Psychotherapy, Erasmus MC, Rotterdam, The Netherlands.
Eva S V
ES
Eijk
Jan J V
JJ
Busschbach
Helma
H
Monteban
Reinier
R
Timman
Marijke Wefers
MW
Bettink-Remeijer
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059026:Diagnostic Self Evaluation; D004636:Emergency Service, Hospital; D005260:Female; D006304:Health Status; D006782:Hospitals, Special; D006801:Humans; D008297:Male; D008875:Middle Aged; D009885:Ophthalmology / Q000145:classification*; D012680:Sensitivity and Specificity; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D014218:Triage / Q000145:classification* / Q000379:methods
emergency department; ophthalmology; self-assessment; self-triage; triage