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The present study sought to assess the validity and reliability of a pilot version of the tool in a resource\u2010limited ED in regional Papua New Guinea.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This pragmatic prospective observational study, conducted at Mount Hagen Provincial Hospital, commenced 1\u2009month after IITT implementation. The facility did not have a pre\u2010existing triage system. All ED patients presenting within a 5\u2010month period were included. The primary outcome was sensitivity for the detection of time\u2010critical illness, defined by 10 pre\u2010specified diagnoses. The association between triage category and ED outcomes was examined using Cramer's<jats:italic>V<\/jats:italic>correlation coefficient. Reliability was assessed by inter\u2010rater agreement between a local and an experienced external triage officer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 9437 presentations during the study period and 9175 (97.2%) had a triage category recorded. Overall, 138 (1.5%) were classified as category 1 (emergency), 1438 (15.7%) as category 2 (priority) and 7599 (82.8%) as category 3 (non\u2010urgent). When applied by a mix of community health workers, nurses, health extension officers and doctors, the tool's sensitivity for the detection of time\u2010critical illness was 77.8% (95% confidence interval 64.4\u201388.0). The admission rate was 14.5% (20\/138) among emergency patients, 12.0% (173\/1438) among priority patients and 0.4% (30\/7599) among non\u2010urgent patients (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.00). Death in the ED occurred in 13 (9.4%) of 138 emergency patients, 34 (2.4%) of 1438 priority patients and four (0.1%) of 7599 non\u2010urgent patients (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.00). The negative predictive value for these outcomes was &gt;99.5%. Among 170 observed triage assessments, weighted<jats:italic>\u03ba<\/jats:italic>was 0.81 (excellent agreement). On average, it took clinicians 2\u00a0min 43\u2009s (standard deviation 1:10) to complete a triage assessment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>There is limited published data regarding the predictive validity and inter\u2010rater reliability of the IITT. In this pragmatic study, the pilot version of the tool demonstrated adequate performance. Evaluation in other emergency care settings is recommended.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1742-6723.13877","type":"journal-article","created":{"date-parts":[[2021,10,10]],"date-time":"2021-10-10T17:08:00Z","timestamp":1633885680000},"page":"99-107","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Validity and reliability of the Interagency Integrated Triage Tool in a regional emergency department in Papua New Guinea"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6422-3348","authenticated-orcid":false,"given":"Rob","family":"Mitchell","sequence":"first","affiliation":[{"name":"Emergency and Trauma Centre Alfred Health Melbourne Victoria Australia"},{"name":"School of Public Health and Preventive Medicine Monash University Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John J","family":"McKup","sequence":"additional","affiliation":[{"name":"Emergency Department Mount Hagen Provincial Hospital Mount Hagen Papua New Guinea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin","family":"Banks","sequence":"additional","affiliation":[{"name":"Emergency Department Townsville University Hospital Townsville Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Regina","family":"Nason","sequence":"additional","affiliation":[{"name":"Emergency Department Mount Hagen Provincial Hospital Mount Hagen Papua New Guinea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5763-917X","authenticated-orcid":false,"given":"Gerard","family":"O'Reilly","sequence":"additional","affiliation":[{"name":"Emergency and Trauma Centre Alfred Health Melbourne Victoria Australia"},{"name":"School of Public Health and Preventive Medicine Monash University Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scotty","family":"Kandelyo","sequence":"additional","affiliation":[{"name":"Emergency Department Port Moresby General Hospital Port Moresby Papua New Guinea"},{"name":"National Department of Health Port Moresby Papua New Guinea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6134-3849","authenticated-orcid":false,"given":"Sarah","family":"Bornstein","sequence":"additional","affiliation":[{"name":"Global Emergency Care Desk Australasian College for Emergency Medicine Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Travis","family":"Cole","sequence":"additional","affiliation":[{"name":"Emergency Department Townsville University Hospital Townsville Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teri","family":"Reynolds","sequence":"additional","affiliation":[{"name":"Department of Integrated Health Services World Health Organization Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulus","family":"Ripa","sequence":"additional","affiliation":[{"name":"Mount Hagen Provincial Hospital Mount Hagen Papua New Guinea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"K\u00f6rver","sequence":"additional","affiliation":[{"name":"Global Emergency Care Desk Australasian College for Emergency Medicine Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1443-557X","authenticated-orcid":false,"given":"Peter","family":"Cameron","sequence":"additional","affiliation":[{"name":"Emergency and Trauma Centre Alfred Health Melbourne Victoria Australia"},{"name":"School of Public Health and Preventive Medicine Monash University Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,10,9]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/1742-6723.13373"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/emj.2009.077081"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-026471"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2018.09.022"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/1757-7241-19-42"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanwpc.2020.100002"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/MEJ.0000000000000445"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12887-017-0796-x"},{"key":"e_1_2_9_10_1","first-page":"53","article-title":"The Cape Triage Score \u2013 a triage system for South Africa","volume":"96","author":"Wallis L","year":"2006","journal-title":"S. 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