title: Reliability of Canadian Emergency Department Triage and Acuity Scale (CTAS) in Saudi Arabia.
abstract: BACKGROUND
  The Canadian Emergency Department Triage and Acuity Scale (CTAS) is an integral part of the Canadian emergency medicine triaging system. There is growing interest and implementation of CTAS worldwide. However, little is known about its reliability outside Canada. The aim of this study was to determine the reliability agreement of CTAS in a tertiary care emergency center in Saudi Arabia.
  
  
  METHODS
  Ten triage nurses (five senior and five junior nurses) utilized CTAS guidelines to independently assign a triage level for 160 real case-based scenarios. Quadratic weighted kappa statistics were used to measure raters' agreements.
  
  
  RESULTS
  Raters provided 1600 triage category assignments to case scenarios for analysis. Intra-rater agreement was similar for both senior and junior nurses; for senior nurses (SN1) kappa 0.871 95 % CI (0.840-0.897), and for junior nurses (SN2) kappa 0.871 95 % CI (0.839-0.898). Inter-rater agreement for the SN1 versus SN2 nurses had statistically meaningful agreement across different triage levels (weighted kappa = 0.770) 95 % CI (0.742-0.797).
  
  
  CONCLUSIONS
  CTAS has good reliability among emergency department (ED) triage nurses in King Abdulaziz Medical City (KAMC), Saudi Arabia. The findings suggest that CTAS might be a reliable instrument when applied in countries outside Canada.
authors.affiliation: Department of Anesthesia, Critical Care Medicine Program, Faculty of Health Sciences, McMaster University, 1280 Main St. W, Hamilton, ON, L8S 4K1, Canada, alqurainim@hhsc.ca.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Alquraini
authors.forename: Emad
authors.initials: E
authors.lastname: Awad
authors.forename: Ra'ed
authors.initials: R
authors.lastname: Hijazi