Optimization of Treatment Priority of the Manchester Triage System (OPTIMTS)

In the emergency department, the urgency for treating patients is determined according to the Manchester Triage System. The parameters collected in this process are deterministically translated into a treatment priority.

The Manchester Triage System (MTS), which has been in use for at least 20 years, is a widely used, validated and standardized procedure for initial assessment in the emergency department - this initial assessment (triage) is done to prioritize medical assistance at a central point. Especially in emergency situations, critically endangered patients often require the deployment of a large part of the available staff at the same time - the medically correct triage of patients according to objective criteria in order to enable an adequate allocation of the available resources at the right time is the main objective. In the optimal case, each patient is treated by medical professionals within the time frame that is adequate for his/her health condition.

Using artificial intelligence methods, it may be possible to increase the accuracy of treatment priority assignment. In the best case, incorrect prioritization of patients can be prevented and medical care can be ensured for those patients who actually need it most urgently.

However, initial assessment, even if standardized and validated, still runs under limited resource conditions - time, space, material and personnel. Last but not least, the very idea of conducting an initial assessment limits its validity, and the results of the allocation fluctuate according to current research, although the determinants of this are currently unknown.

Study Overview

• Status: Completed
• Conditions: Triage
• Intervention / Treatment: Other: Admission to General Ward; Other: 30 Day Mortality; Other: Admission to Intensive Care Unit

• Study Type: Observational
• Enrollment (Actual): 77976

Contacts and Locations

Study Locations

• Austria
  • Upper Austria
    • Linz, Upper Austria, Austria, 4021
      • Kepler University Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: N/A

• Sampling Method: Non-Probability Sample

Study Population

As described in the inclusion criteria.

Description

Inclusion Criteria:

• All adult patients that were triaged at the emergency department at the Kepler University Hospital in the period between 2015-12-01 to 2020-08-31.

Exclusion Criteria:

• None.

Study Plan

How is the study designed?

Design Details

• Observational Models: Cohort
• Time Perspectives: Retrospective

Number of groups / cohorts

6

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Admission to General Ward Positive	Other: Admission to General Ward; Admission to General Ward
30 Day Mortality Positive	Other: 30 Day Mortality; 30 Day Mortality
Admission to Intensive Care Unit Positive	Other: Admission to Intensive Care Unit; Admission to Intensive Care Unit
Admission to General Ward Negative
30 Day Mortality Negative
Admission to Intensive Care Unit Negative

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
AUROC for Classification of Admission to General Ward	AUROC for Classification of Admission to General Ward	2015-12-01 to 2020-08-31
AUROC for Classification of Admission to Intensive Care Unit	AUROC for Classification of Admission to Intensive Care Unit	2015-12-01 to 2020-08-31
AUROC for Classification of 30 Day Mortality	AUROC for Classification of 30 Day Mortality	2015-12-01 to 2020-08-31

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Confusion Matrix	Confusion Matrix Results: true positives, true negatives, false positive, false negatives and values calculated from these results.	2015-12-01 to 2020-08-31

Collaborators and Investigators

• Sponsor: Kepler University Hospital
• Investigators: Principal Investigator: Thomas Tschoellitsch, MD, Kepler University Hospital and Johannes Kepler University, Linz, Austria

Study record dates

Study Major Dates

• Study Start (Actual): June 1, 2022
• Primary Completion (Actual): July 31, 2022
• Study Completion (Actual): July 31, 2022

Study Registration Dates

• First Submitted: July 12, 2022
• First Submitted That Met QC Criteria: July 23, 2022
• First Posted (Actual): July 26, 2022

Study Record Updates

• Last Update Posted (Actual): May 3, 2023
• Last Update Submitted That Met QC Criteria: April 29, 2023
• Last Verified: April 1, 2023

More Information

Terms related to this study

• Other Study ID Numbers: OPTIMTS

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No