Table 3 Included validation studies of pediatric triage tools

Mortality

ESI

Jafari-Rouhi [17] 2013 Iran (Upper Middle Income)

n = 1104 ED at national teaching hospital. (100% <18 y/o)

Overall: 0.9% 1: 100% 2: 1.2% 3:0% 4:0% 5: 0%

Outcome was ICU admission or death. ESI performed at patient presentation, not admission.

TOPRS

Bains 2012 [15] India (Lower-middle Income)

n = 777 Teaching hospital with general ED.

Overall: 16.3%

TORPS 6: 100% TORPS 5: 80.0% TORPS 4: 66.7% TORPS 3: 60.0% TORPS 2: 38.2% TORPS 1: 12.5%

TOPRS 0: 4.4%

All patients were admitted to ED. ROC curve maximal discrimination at 2.5 (sensitivity 79.6%, specificity 74.3%)

PATS

Mullan 2014 [ ] Botswana (Upper-middle Income)

n = 4466

ED at terteriary referral hospital

(100% < 13 y/o)

Overall: 0.16%

Red: 1.4%

Orange: 0.05%

Yellow: 0%

Green: 0%

Outcome was ICU admission or death. PATS performed at ED presentation. Large study of both adult and pediatric patients with separate analyses.

Admission

ESI

Jafari-Rouhi 2013 [17] Iran (Upper-middle Income)

n = 1104 ED at national teaching hospital. (100% <18 y/o)

Overall: 9.4% 1: 0% 2: 29.8% 3: 1.8% 4: 2.0% 5: 0%

Outcome was ED admission or ward admission (does not include ICU admission). Spearman correlation coeficient 0.407.

Adapted ETAT

Buys 2013 [10] South Africa (Upper-middle Income)

n = 407 District hospital with general ED. (100% < 16y/o)

Overall: 24.8% P1: 91.7% P2: 36.9% P3: 10.1%

Second of 2 cohorts (2009), first (2007) immediately following training.

pSATS

Twomey 2013 [18] South Africa (Upper-middle Income)

n = 2014 6 ED centers with varying size/populations. (100% <13 y/o)

Overall: 21.5% 1: 72.8% 2: 29.0% 3: 27.9% 4: 4.7%

Sensitivity 91.0%, Specificity 54.5%. Compared to simply TEWS or clinical discriminator, and improved discrimination.

ETAT

Robertson 2001 [7] Malawi (Low Income)

n = 2281 Under 5 outpatient clinic with referral for admission (85% <5 y/o)

Overall: 14.9% P1: 90.0% P2: 32.0% P3: 4.5%

No follow-up data after admission. Only patients under 5.

PEWS

Chaiyakulsil 2015 [16] Thailand (Upper-Middle income)

n = 1136

ED at large tertiary hospital

(100% < 15y/o)

Overall AUC: 0.73

ICU: 0.98

Ward 0.71

PEWS > 1 for admission

Sensitivity 77%

Specificity 59%

Measured in area under ROC curve, for sensitivity and specificity for admission by PEWS category.

PATS

Mullan 2014 [ ]

Botswana

(Upper-middle Income)

N = 4466

ED at terteriary referral hospital

(100% < 13 y/o)

Overall: 54.5%

Red: 86.7%

Orange: 66.1%

Yellow: 37.6%

Green: 20.6%

PATS performed at ED presentation. Large study of both adult and pediatric patients with separate analyses.