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Regression to Middle Effect May Threaten Validity of Triage Scales; a Letter to Editor

Amir Mirhaghi, Mohsen Ebrahimi




Triage is sorting patients based on acuity in order to manage care in the emergency department (ED) {Mirhaghi, 2017 #60}(1). Medical institutes are trying to develop triage scales compatible with their own culture of care. A triage scale must be precise and comprehensive enough to guide triage nurses and eliminate uncertainty.


triage; validity; emergency


Mirhaghi A, Ebrahimi M.. The Australasian Triage Scale Level 5 Criteria may need to be revised. Emerg (Tehran). 2017;5(1):e50. Epub 2017 Jan 14.

Kwon H, Kim YJ, Jo YH, Lee JH, Lee JH, Kim J, Hwang JE, Jeong J, Choi YJ. The Korean Triage and Acuity Scale: associations with admission, disposition, mortality and length of stay in the emergency department. Int J Qual Health Care. 2018 Aug 25. doi: 10.1093/intqhc/mzy184. [Epub ahead of print]

Kulas JT, Stachowski AA. Middle category endorsement in odd-numbered Likert response scales: Associated item characteristics, cognitive demands, and preferred meanings. Journal of Research in Personality. 2009 Jun 1;43(3):489-93. Doi: 10.1016/j.jrp.2008.12.005.

Kim JH, Kim JW, Kim SY, Hong DY, Park SO, Baek KJ, Lee KR. Validation of the Korean Triage and Acuity Scale Compare to Triage by Emergency Severity Index for Emergency Adult Patient: Preliminary Study in a Tertiary Hospital Emergency Medical Center. J Korean Soc Emerg Med. 2016 Oct;27(5):436-441. Korean.

DOI: https://doi.org/10.22037/emergency.v6i1.23141


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