Assessing the validity of the Triage Risk Screening Tool in a third world setting

Abstract

Background: Social risk is rarely evaluated in older emergency department (ED) patients, although its identification can reduce re-attendance. Objectives: This study assessed the diagnostic accuracy of the Triage Risk Screening Tool (TRST) in the ED of a developing country. Methods: The diagnostic accuracy of the TRST to detect elderly adults in need of social service intervention was compared with routine clinical evaluation, using comprehensive evaluation by an experienced social worker as the “gold standard”. The inter-rater reliability of the TRST was assessed on a separate cohort of patients prior to the main study. Results: The sensitivity of the TRST was 94.7% versus 55.6% for physician assessment. The TRST had good inter-rater reliability (Cohen’s kappa =.882), and physicians found it easy to use. Conclusion: The TRST provides a rapid means of assessing risk in older ED patients. This study confirmed the validity of this screening tool in a third world setting.