Sistemas de triaje pediátrico en urgencias hospitalarias: revisión bibliográfica
Bibliographic record
Abstract
espanolMetodologia: Revision bibliografica en las bases de datos Medline, Cochrane Library, Cuiden, PubMed, MEDES y SciELO sobre sistemas de triaje pediatrico. Se utilizaron los instrumentos SIGN CASPe y Berra et al. para la valoracion de los articulos. Resultados: Se incluyeron 25 articulos de alta calidad. Los sistemas de triaje pediatrico incorporados en el ambito hospitalario y con mejores puntuaciones respecto a la validez y fiabilidad son el Sistema de clasificacion de Manchester (MTS), el Indice de gravedad de emergencia (ESI), el Triangulo de Evaluacion Pediatrica (TEP), la Escala de Triaje y Agudeza Pediatrica Canadiense (PaedCTAS) y el Sistema de Alerta Temprana (SAT). La sensibilidad es de 79, 90, 81, 85 y 80% y, la especificidad es de 85, 80, 87, 80 y 85% respectivamente. Tambien se consideran sistemas de triaje alternativos con diseno especifico para otros contextos. Discusion: Las competencias de la enfermera en triaje deben estar vinculadas a la asignacion del nivel de clasificacion y a otras competencias. El juicio y razonamiento clinico permiten iniciar la planificacion de los cuidados. Son necesarios futuros estudios para valorar las bondades y/o dificultades de los sistemas de triaje en distintos entornos y explorar aspectos que vinculen su uso en la atencion clinicas con la planificacion en cuidados. EnglishMethodology: Bibliographic research in Medline, Cochrane Library, Cuiden, PubMed, MEDES and SciELO databases about triage systems in the pediatric population. SIGN, CASPe and Berra et al. instruments were used for the evaluation of them. Results: A total of 25 high quality articles were included. The Manchester Classification System (MTS), the Emergency Severity Index (ESI), the Pediatric Evaluation Triangle (TEP), the Canadian Pediatric Triage and Acuity Scale (PaedCTAS) and the Early Warning System (SAT) were the most common triage systems for pediatric care in hospital and had the best scores regarding validity and reliability. The sensitivity is 79, 90, 81, 85 and 80% respectively, and the specificity is 85, 80, 87, 80 and 85% respectively. Alternative triage systems and specific designs are also taken into account instead of traditional ones. Discussion: The competencies of the triage nurse should be linked to the assignment of the classification level and to other competencies. Clinical judgment and reasoning allow initiating care planning. Future studies are necessary to assess the benefits and / or difficulties of triage systems in different settings and to explore aspects that link their use in clinical care with care planning.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.008 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.001 | 0.006 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".