title: Inter-rater Reliability of Triages Performed by the Electronic Triage System.
abstract: OBJECTIVE
  To examine the inter-rater reliability of triages performed by the Electronic Triage System (ETS) which has recently developed and used in hospital emergency department (ED).
  
  
  METHODS
  This cross-sectional study was conducted prospectively and studied 408 visitors of Tabriz Imam Reza hospital's ED. The variables of interest were age, sex, nurse-assigned triage category, physician-assigned triage category, disease type (trauma, non-trauma), and the referred room within the ED. Cohen's un-weighted kappa, linear weighted kappa, and quadratic weighted kappa were used to describe the reliability.
  
  
  RESULTS
  Un-weighted kappa observed to be 0.186 (95% CI: 0.123-0.249). Linear weighted kappa observed as 0.317 (95% CI: 0.251-0.384) and quadratic weighted kappa as 0.462 (95% CI: 0.336-0.589). In general, low agreement was seen between the triage nurses and ED physicians. For trauma patients and for those who were referred to the cardiopulmonary resuscitation room (CPR), all three types of kappa were higher than other visitors of the ED.
  
  
  CONCLUSIONS
  Inter-rater reliability of the triages performed by the ETS observed as ranging from poor to moderate. Implementing interventions that would create a common language between nurses and physicians about the triage of the ED visitors seems necessary. The more agreement on the triage of trauma and CPR patients might be due to their condition and the more attention to them.
authors.affiliation: Road Traffic Injury Research Center and Department of Medical Informatics, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran  
authors.forename: Faramarz
authors.initials: F
authors.lastname: Pourasghar
authors.affiliation: Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran ; Iranian Center of Excellence in Health Management, Tabriz University of Medical Sciences, Tabriz, Iran 
authors.forename: Amin
authors.initials: A
authors.lastname: Daemi
authors.affiliation: Health Services Management Research Center, School of Health management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran  
authors.forename: Jafar Sadegh
authors.initials: JS
authors.lastname: Tabrizi
authors.affiliation: Department of Emergency Medicine, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Ala
keywords: Hospital Emergency Service; Inter-rater Reliability; Triage