title: Is a mobile emergency severity index (ESI) triage better than the paper ESI?
abstract: This study aims to evaluate the mobile emergency severity index (ESI) tool in terms of validity compared with the original ESI triage. The original ESI and mobile ESI were used with patients at the Department of Emergency Medicine, Ramathibodi Hospital, Thailand. Eligible patients were evaluated by sixth-year medical students/emergency physicians using either the original or mobile ESI. The ESI results for each patient were compared with the standard ESI. Concordance and kappa statistics were calculated for pairs of the evaluators. There were 486 patients enrolled in the study; 235 patients (48.4%) were assessed using the mobile ESI, and 251 patients (51.6%) were in the original ESI group. The baseline characteristics of patients in both groups were mostly comparable except for the ED visit time. The percentages of concordance and kappa statistics in the original ESI group were lower than in the mobile group in all three comparisons (medical students vs gold standard, emergency physicians vs gold standard, and medical students vs emergency physicians). The highest kappa in the original ESI group is 0.69, comparing emergency physicians vs gold standard, while the lowest kappa in the application group is 0.84 comparing the medical students vs gold standard. Both medical students and emergency physicians are more confident with the mobile ESI application triage. In conclusion, the mobile ESI has better inter-rater reliability, and is more user-friendly than the original paper form.
authors.affiliation: Emergency Medicine Department, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand.
authors.forename: Sorravit
authors.initials: S
authors.lastname: Savatmongkorngul
authors.affiliation: Emergency Medicine Department, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand.
authors.forename: Chaiyaporn
authors.initials: C
authors.lastname: Yuksen
authors.affiliation: Emergency Medicine Department, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand.
authors.forename: Chanakarn
authors.initials: C
authors.lastname: Suwattanasilp
authors.affiliation: Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.|Research Center in Back, Neck Other Joint Pain and Human Performance (BNOJPH), Khon Kaen, Thailand.|Non-communicable Diseases Research Group, Khon Kaen University, Khon Kaen, Thailand.
authors.forename: Kittisak
authors.initials: K
authors.lastname: Sawanyawisuth
authors.affiliation: Emergency Medicine Department, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand. yuwares.sit@mahidol.ac.th.
authors.forename: Yuwares
authors.initials: Y
authors.lastname: Sittichanbuncha
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004635:Emergency Medicine / Q000379:methods / Q000592:standards; D004636:Emergency Service, Hospital / Q000458:organization & administration; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D063731:Mobile Applications / Q000592:standards* / Q000639:trends; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D012985:Software Design; D011795:Surveys and Questionnaires; D013785:Thailand; D014218:Triage / Q000379:methods* / Q000592:standards*
keywords: Concordance; Emergency severity index; Emergency triage; Kappa; Mobile application; Reliability