Project II - Improving trauma triage after serious events

One of the most central parts of trauma care is triage; defined as the prioritization of the severely injured according to their needs, chances of survival, and available resources. The process of triage requires a highly developed clinical ability to adequately judge patients' chances of survival. To aid trauma care providers, extensive research has focused on the development of accurate mortality prediction models. In the trauma care context, a prediction model can also be referred as a prognostic model, risk score, and triage score, and aims to provide trauma care providers with an estimate of a patient's probability of survival, to understand prognosis, guide treatment and improve resource utilization. This estimate is often based on several different parameters, such as physiological, anatomical injury, and mechanism of injury.

Most established prediction models have now been criticized for methodological limitations. The literature of prediction modelling is growing, and this development has driven demands for increased methodological rigor. Key issues in trauma prediction modelling include methods to derive and validate models, including how to deal with continuous varibales such as vital signs and missing data. Another current hot topic is the transferability of a model developed in one setting to use in another setting without adjustment.

In this project, we aim to generate knowledge on methodological issues in trauma prediction modelling, such as transferability, validation, updating and adjustment for regional versus national use, and handling of continuous vital sign data, as well as missing data. This year, we aim to create conditions for improved trauma triage after serious events by further studying methods for the development and applying clinical prediction models for use in clinical settings. 

Objectives 2017

  1. To study the portability of clinical prediction models for trauma triage between the different contexts in Sweden
  2. To examine how international clinical prediction models for trauma triage can be adapted to the Swedish context
  3. To compare the performance of existing clinical prediction models for trauma triage
  4. To compare medical triage to triage based on clinical prediction models