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dc.contributor.authorSherwood Forest Hospitals NHS Foundation Trust
dc.date.accessioned2020-10-08T14:12:38Z
dc.date.available2020-10-08T14:12:38Z
dc.date.issued2020-09
dc.identifier.citationPrognostic accuracy of emergency department triage tools for children with suspected COVID-19: The PRIEST observational cohort study Katie Biggs, Ben Thomas, Steve Goodacre, Ellen Lee, Laura Sutton, Matthew Bursnall, Amanda Loban, Simon Waterhouse, Richard Simmonds, Carl Marincowitz, Jose Schutter, Sarah Connelly, Elena Sheldon, Jamie Hall, Emma Young, Andrew Bentley, Kirsty Challen, Chris Fitzsimmons, Tim Harris, Fiona Lecky, Andrew Lee, Ian Maconochie, Darren Walter medRxiv 2020.09.01.20185793; doi: https://doi.org/10.1101/2020.09.01.20185793en
dc.identifier.otherISRCTN 28342533
dc.identifier.otherIRAS: 101138
dc.identifier.urihttps://orda.derbyhospitals.nhs.uk/handle/123456789/2327
dc.descriptionPreprint CC-BY 4.0 International license.en
dc.description.abstractObjectives: Emergency department clinicians can use triage tools to predict adverse outcome and support management decisions for children presenting with suspected COVID-19. We aimed to estimate the accuracy of triage tools for predicting severe illness in children presenting to the emergency department (ED) with suspected COVID-19 infection. Methods: We undertook a mixed prospective and retrospective observational cohort study in 44 EDs across the United Kingdom (UK). We collected data from children attending with suspected COVID-19 between 26 March 2020 and 28 May 2020, and used presenting data to determine the results of assessment using the WHO algorithm, swine flu hospital pathway for children (SFHPC), Paediatric Observation Priority Score (POPS) and Childrens Observation and Severity Tool (COAST). We recorded 30-day outcome data (death or receipt of respiratory, cardiovascular or renal support) to determine prognostic accuracy for adverse outcome. Results: We collected data from 1530 children, including 26 (1.7%) with an adverse outcome. C-statistics were 0.80 (95% confidence interval 0.73-0.87) for the WHO algorithm, 0.80 (0.71-0.90) for POPS, 0.76 (0.67-0.85) for COAST, and 0.71 (0.59-0.82) for SFHPC. Using pre-specified thresholds, the WHO algorithm had the highest sensitivity (0.85) and lowest specificity (0.75), but POPS and COAST could optimise sensitivity (0.96 and 0.92 respectively) at the expense of specificity (0.25 and 0.38 respectively) by using a threshold of any score above zero instead of the pre-specified threshold. Conclusion: Existing triage tools have good but not excellent prediction for adverse outcome in children with suspected COVID-19. POPS and COAST could achieve an appropriate balance of sensitivity and specificity for supporting decisions to discharge home by considering any score above zero to be positive.en
dc.description.sponsorshipUnited Kingdom National Institute for Health Research Health Technology Assessment (HTA) programmeen
dc.language.isoenen
dc.subjectCovid-19en
dc.subjectClinical Trialen
dc.subjectChildrenen
dc.subjectEmergency Medicineen
dc.subjectTriageen
dc.subjectPRIESTen
dc.titlePrognostic accuracy of emergency department triage tools for children with suspected COVID-19: The PRIEST observational cohort study.en
dc.typeArticleen


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