From pen-and-paper questionnaire to a computer-assisted instrument for self-triage in the ophthalmic emergency department: Process and validation

Eva Eijk, MW Bettink-Remeijer, Reinier Timman, Jan van Busschbach

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Background/Aims: The ISET (Instrument for SElf-Triage) is a validated pen-and-paper instrument for patient self-triage in ophthalmic emergency departments. The aim of the present study is to develop a validated computer-assisted ISET (ca-ISET) with a touch screen. Methods: In the emergency department of the Eye Hospital Rotterdam, the Netherlands, successive computer-assisted versions of the ISET were tested by patients visiting the emergency department. The versions were developed by iteratively prototyping, testing, analysing and refining the computer-assisted ISET. In three test cycles, 16, 53 and 75 patients >= 18 years old, visiting the emergency department for the first time with their ophthalmic complaint, were monitored while using the ca-ISET. They were debriefed, and their input was used to adapt the computer-assisted ISET. To validate the ca-ISET, a sensitivity outcome of.80 and a specificity of.70 was required (CI=95%). The ca-ISET sensitivity and specificity were tested by comparing ca-ISET triage outcome to triage outcome as decided by the regular triage assistant. Results: ISET accuracy increased from 0.69 in the first test to 0.79 in the third test. Sensitivity increased from 0.66 (CI 0.13-0.98) to 0.80 (0.51-0.95). Specificity increased from 0.69 (0.39-0.90) to 0.78 (0.65-0.88). To improve validity and usability, several adjustments were made in the text and the flow chart of the computer-assisted ISET. Conclusions: A ca-ISET prototype was developed, with minor textual modification of the pen-and-paper version. The new ca-ISET was validated by comparing against triage decided by the regular triage assistant. (C) 2015 Elsevier Ltd. All rights reserved.
Original languageUndefined/Unknown
Pages (from-to)258-262
Number of pages5
JournalComputers in Biology and Medicine
Publication statusPublished - 2015

Research programs

  • EMC NIHES-04-58-01

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