Parenti Nicola, Reggiani Maria Letizia Bacchi, Iannone Primiano, Percudani Daniela, Dowding Dawn
University of Parma, Parma, Italy.
Biostatistic, University of Bologna, Italy.
Int J Nurs Stud. 2014 Jul;51(7):1062-9. doi: 10.1016/j.ijnurstu.2014.01.013. Epub 2014 Feb 2.
To conduct a systematic review to check the level of validity and reliability of the Manchester Triage System and the quality of reporting of literature on this topic.
This is a systematic review based on the PRISMA guideline on reporting systematic reviews.
The systematic search of the international literature published from 1997 through 30 November 2012 in the PubMed, Embase, Cochrane Library, Cinahl, Web of Knowledge, and Scopus databases.
This review included quantitative and qualitative research investigating the reliability and validity of the Manchester Triage System for the broad population of adults and children visiting the emergency department. After a systematic selection process, included studies were assessed on their quality by three researchers using the STARD guidelines.
Twelve studies were included in the review. The studies investigated the inter- and intra-rater reliability using the "kappa" statistic; the validity was tested with many measures: validity in predicting mortality, hospital admission, under- and overtriage, used resources, and length of stay in the emergency department, as well as a reference standard rating.
In this review, the Manchester Triage System shows a wide inter-rater agreement range with a prevalence of good and very good agreement. Its safety was low because of the high rate of undertriage and the low sensitivity in predicting higher urgency levels. The high rate of overtriage could cause unnecessarily high use of resources in the emergency department. The quality of the reporting in studies of the reliability and validity of the Manchester Triage System is good.
进行一项系统评价，以检验曼彻斯特分诊系统的有效性和可靠性水平以及关于该主题文献的报告质量。
这是一项基于PRISMA系统评价报告指南的系统评价。
对1997年至2012年11月30日在PubMed、Embase、Cochrane图书馆、Cinahl、Web of Knowledge和Scopus数据库中发表的国际文献进行系统检索。
本评价纳入了针对前往急诊科的广大成人和儿童人群，调查曼彻斯特分诊系统可靠性和有效性的定量和定性研究。经过系统筛选过程后，由三名研究人员使用STARD指南对纳入研究的质量进行评估。
本评价纳入了12项研究。这些研究使用“kappa”统计量调查了评分者间和评分者内的可靠性；通过多种测量方法检验有效性：预测死亡率、住院、分诊不足和过度分诊、使用的资源以及在急诊科的停留时间的有效性，以及参考标准评级。
在本评价中，曼彻斯特分诊系统显示出评分者间的广泛一致性范围，且普遍存在良好和非常好的一致性。由于分诊不足率高以及预测较高紧急程度时的敏感性低，其安全性较低。过度分诊率高可能导致急诊科资源的不必要高消耗。关于曼彻斯特分诊系统可靠性和有效性研究的报告质量良好。
