2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T656,While one in four Australians living with disability aged <65 years presents to the emergency department, a significant proportion could potentially be managed more effectively by primary care. Through their daily work, disability support workers (DSWs) are valuable in identifying changes in health for people living with a disability. Yet, with no minimum certifications, DSWs often have limited clinical knowledge. This paper describes the development and implementation of a co-designed triage support tool (Tool) for DSWs to determine the most appropriate urgency and care pathway for their clients. The development of the Tool formed part of the co-design of a virtual pathway to provide urgent care to people living with disability through their DSWs. Over 6 months, the Tool was developed, implemented and reviewed with key stakeholders, including disability service providers. Following development, the Tool was successfully implemented across the pilot disability service providers and evaluated over a 3-month period. Evaluation showed high staff acceptability, with 78% reporting it supported their decision making. The Tool demonstrates the potential to support DSWs in determining the most suitable urgent care pathway, provided it remains clear, simple and adaptable. A customised Tool can support DSWs in determining the most appropriate urgency and care pathway for their client in urgent care situations. Primary care services could consider if customised Tools may be helpful for their clients who live with disability or similarly vulnerable populations and the non-clinicians who support their care.31:T8a5, Background While one in four Australians living with disability aged <65 years presents to the emergency department, a significant proportion could potentially be managed more effectively by primary care. Through their daily work, disability support workers (DSWs) are valuable in identifying changes in health for people living with a disability. Yet, with no minimum certifications, DSWs often have limited clinical knowledge. This paper describes the development and implementation of a co-designed triage support tool (Tool) for DSWs to determine the most appropriate urgency and care pathway for their clients. Methods The development of the Tool formed part of the co-design of a virtual pathway to provide urgent care to people living with disability through their DSWs. Over 6 months, the Tool was developed, implemented and reviewed with key stakeholders, including disability service providers. Results Following development, the Tool was successfully implemented across the pilot disability service providers and evaluated over a 3-month period. Evaluation showed high staff acceptability, with 78% reporting it supported their decision making. The Tool demonstrates the potential to support DSWs in determining the most suitable urgent care pathway, provided it remains clear, simple and adaptable. Conclusion A customised Tool can support DSWs in determining the most appropriate urgency and care pathway for their client in urgent care situations. Primary care services could consider if customised Tools may be helpful for their clients who live with disability or similarly vulnerable populations and the non-clinicians who support their care. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Clinical Decision Support Tool: modality Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Clinical Decision Support Tool (modality). Clinician-written summaries and actionable practice insights. 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Key findings are inferred from figures and tables in this supplement.","value_numeric":null}],"summaries":{"what_studied":"The AERO study evaluated the Respiratory Allergy Optimiser (RAO), a clinical decision-support tool, for optimising allergic rhinitis (AR) management in primary care, assessing symptom control (VAS scores), treatment step adjustments, and user experience among patients and healthcare providers (HCPs).","key_result":"Patients with controlled AR symptoms (VAS <20 mm) showed significant VAS improvement at follow-up for the overall group (p=0.017) and the intermittent AR subgroup (p=0.049), but not persistent AR (p=0.111). Partially controlled patients (VAS 20–50 mm) showed a trend toward improvement (p=0.06 for intermittent AR). HCPs rated the RAO positively on the System Usability Scale, and patients reported feeling more involved and better served compared to prior AR consultations.","limitations":"This appears to be a supplementary document only; the full study methods, sample size rationale, comparator design, and primary endpoints are not fully reported here. Subgroup sizes are small (e.g., persistent AR controlled subgroup n=9–11), limiting statistical power. The qualitative HCP and patient quotes reflect a small number of interviews, reducing generalisability.","practice_takeaway":"The RAO structured decision-support tool appears feasible in primary care and may improve symptom control in patients with intermittent AR. Clinicians managing AR in primary care could consider structured optimisation tools to improve consultation quality and treatment adherence."}},{"doi":"10.1097/pec.0000000000003662","pmid":"42478126","title":"A Randomized Trial to Increase Outpatient Asthma Referrals Upon Pediatric Emergency Department Discharge","journal_title":"Pediatric Emergency Care","journal_issn":"0749-5161","published_at":"2026-07-21T00:00:00.000Z","url":"https://doi.org/10.1097/pec.0000000000003662","source_score":1,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-26T13:44:50.273Z","updated_at":"2026-07-26T13:44:50.273Z","tags":[{"paper_doi":"10.1097/pec.0000000000003662","tag_type":"age_group","value":"child","value_numeric":null},{"paper_doi":"10.1097/pec.0000000000003662","tag_type":"category","value":"Emergency Medicine","value_numeric":null},{"paper_doi":"10.1097/pec.0000000000003662","tag_type":"condition","value":"Asthma","value_numeric":null},{"paper_doi":"10.1097/pec.0000000000003662","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1097/pec.0000000000003662","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1097/pec.0000000000003662","tag_type":"modality","value":"Clinical Decision Support Tool","value_numeric":null},{"paper_doi":"10.1097/pec.0000000000003662","tag_type":"sample_size","value":"n=68","value_numeric":68},{"paper_doi":"10.1097/pec.0000000000003662","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1097/pec.0000000000003662","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1097/pec.0000000000003662","tag_type":"warning","value":"Follow-up attendance after referral was not measured, so the clinical downstream impact remains unknown.","value_numeric":null},{"paper_doi":"10.1097/pec.0000000000003662","tag_type":"warning","value":"Provider-level (cluster) randomization was used, but the analysis does not appear to explicitly account for clustering — this may affect the precision of the P-value.","value_numeric":null},{"paper_doi":"10.1097/pec.0000000000003662","tag_type":"warning","value":"Sample size is small (n=68); the large effect size should be interpreted cautiously until replicated in larger trials.","value_numeric":null}],"summaries":{"what_studied":"This RCT tested whether showing ED providers the PACCI-ED tool plus a one-page referral summary increased outpatient asthma referrals at discharge for children aged 5–11 presenting with acute asthma exacerbation (November 2021–April 2023).","key_result":"Referrals at ED discharge were 63.9% in the intervention group vs. 6.3% in controls — a roughly 10-fold increase (P<0.0001); most referrals went to a community asthma program (68%) or subspecialty clinic (28%).","limitations":"Small sample size (n=68 total) limits generalizability; provider-level randomization may introduce clustering effects; the study did not track whether referred patients actually attended follow-up appointments.","practice_takeaway":"Using a structured asthma control tool like the PACCI-ED at ED discharge can dramatically increase referral rates — especially for children with poorly controlled asthma. Consider embedding a similar tool into your ED discharge workflow to connect high-risk pediatric asthma patients to outpatient care."}},{"doi":"10.1016/j.afjem.2026.100972","pmid":"42064584","title":"Assessment of Sydney Triage to Admission Risk Tool (START) on Egyptian Emergency Department performance","journal_title":"African Journal of Emergency Medicine","journal_issn":"2211-419X","published_at":"2026-04-22T00:00:00.000Z","url":"https://doi.org/10.1016/j.afjem.2026.100972","source_score":2,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-07T22:49:38.208Z","updated_at":"2026-05-07T22:49:38.208Z","tags":[{"paper_doi":"10.1016/j.afjem.2026.100972","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.afjem.2026.100972","tag_type":"brand","value":"START (Sydney Triage to Admission Risk Tool)","value_numeric":null},{"paper_doi":"10.1016/j.afjem.2026.100972","tag_type":"category","value":"Emergency Medicine","value_numeric":null},{"paper_doi":"10.1016/j.afjem.2026.100972","tag_type":"condition","value":"Emergency Department Overcrowding","value_numeric":null},{"paper_doi":"10.1016/j.afjem.2026.100972","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.afjem.2026.100972","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1016/j.afjem.2026.100972","tag_type":"modality","value":"Clinical Decision Support Tool","value_numeric":null},{"paper_doi":"10.1016/j.afjem.2026.100972","tag_type":"sample_size","value":"n=399","value_numeric":399},{"paper_doi":"10.1016/j.afjem.2026.100972","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.afjem.2026.100972","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1016/j.afjem.2026.100972","tag_type":"warning","value":"Randomization was performed by arrival day (cluster-like allocation) rather than individual patient randomization, which may introduce selection bias not fully captured by the reported baseline comparisons.","value_numeric":null},{"paper_doi":"10.1016/j.afjem.2026.100972","tag_type":"warning","value":"Several references in the paper are incomplete or missing (listed only as numbered placeholders), limiting full appraisal of the cited evidence base.","value_numeric":null},{"paper_doi":"10.1016/j.afjem.2026.100972","tag_type":"warning","value":"The AUC of 0.92 reported here is notably higher than the 0.80–0.82 seen in the original Australian START validation studies, which may reflect population or setting differences.","value_numeric":null},{"paper_doi":"10.1016/j.afjem.2026.100972","tag_type":"warning","value":"The nearly 50% relative mortality reduction (5% vs. 10.6%) is striking for a triage tool alone; unmeasured confounders and a single-center design mean this result should be interpreted cautiously until replicated.","value_numeric":null}],"summaries":{"what_studied":"This RCT evaluated the Sydney Triage to Admission Risk Tool (START) versus standard triage in 399 adult ED patients at Menoufia University Hospital, Egypt, over 6 months (July–December 2024), focusing on ED length of stay, 4-hour discharge rates, and mortality.","key_result":"START reduced mean ED length of stay (204 vs. 235 min, p=0.02), raised the proportion discharged within 4 hours (84% vs. 74%, p=0.01), and cut mortality nearly in half (5% vs. 10.6%, p=0.02). The tool predicted admission with AUC 0.92 (95% CI 0.90–0.95), sensitivity 91.4%, specificity 76.6%.","limitations":"- Single-center study in one Egyptian hospital limits generalizability.\n- Recruitment only on 3 selected days per week may not capture high-volume or weekend surge patterns.\n- Potential observer effect from the research investigator collecting data at the bedside, and unmeasured confounders (e.g., clinician experience) may have influenced results despite randomization.","practice_takeaway":"Adding START to routine ED triage may meaningfully cut patient time in the department and reduce mortality, especially in well-resourced settings. Clinicians can use it as a complement to—not a replacement for—clinical judgment at triage."}},{"doi":"10.1071/py25057","pmid":"41370638","title":"Developing a co-designed triage support tool for disability support workers to determine the most appropriate urgency and care pathway for their clients","journal_title":"Australian Journal of Primary Health","journal_issn":"1448-7527","published_at":"2025-12-10T00:00:00.000Z","url":"https://doi.org/10.1071/py25057","source_score":1,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2026-01-15","doi":"10.1071/py25057","days":"7","issn":"1448-7527","rank":"3","field":"Clinical Medicine","score":"1","category":"Primary Health Care","categories":["Primary Health Care"],"_categories":["Primary Health Care"]},"pubmed":{"doi":"10.1071/PY25057","title":"Developing a co-designed triage support tool for disability support workers to determine the most appropriate urgency and care pathway for their clients.","journal":"Australian journal of primary health","methods":"","results":"Following development, the Tool was successfully implemented across the pilot disability service providers and evaluated over a 3-month period. Evaluation showed high staff acceptability, with 78% reporting it supported their decision making. The Tool demonstrates the potential to support DSWs in determining the most suitable urgent care pathway, provided it remains clear, simple and adaptable.","abstract":"$30","keywords":["education","non-clinician","people living with disability","triage","triage support","urgent care","virtual care","vulnerable population"],"pubmed_id":"41370638","conclusions":"A customised Tool can support DSWs in determining the most appropriate urgency and care pathway for their client in urgent care situations. Primary care services could consider if customised Tools may be helpful for their clients who live with disability or similarly vulnerable populations and the non-clinicians who support their care.","publication_date":"2025-12-10T00:00:00"},"crossref":{"DOI":"10.1071/py25057","URL":"https://doi.org/10.1071/py25057","ISSN":["1448-7527","1836-7399"],"link":[{"URL":"https://connectsci.au/py/article-pdf/doi/10.1071/PY25057/1836710/py25057.pdf","content-type":"application/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https://connectsci.au/py/article-pdf/doi/10.1071/PY25057/1836710/py25057.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":"1","score":1,"title":["Developing a co-designed triage support tool for disability support workers to determine the most appropriate urgency and care pathway for their clients"],"author":[{"given":"David","family":"Nouju","sequence":"first","affiliation":[{"name":"ASouth Australian Virtual Care Service, South Australian Local Health Network, 1 Tonsley Boulevard, Clovelly Park, SA 5042, Australia."}]},{"given":"Darren","family":"Daff","sequence":"additional","affiliation":[{"name":"ASouth Australian Virtual Care Service, South Australian Local Health Network, 1 Tonsley Boulevard, Clovelly Park, SA 5042, Australia."}]},{"given":"Pamela","family":"Everingham","sequence":"additional","affiliation":[{"name":"ASouth Australian Virtual Care Service, South Australian Local Health Network, 1 Tonsley Boulevard, Clovelly Park, SA 5042, Australia."}]}],"issued":{"date-parts":[[2026,1,6]]},"member":"67","prefix":"10.1071","source":"Crossref","volume":"32","created":{"date-time":"2025-12-10T19:26:31Z","timestamp":1765394791000,"date-parts":[[2025,12,10]]},"indexed":{"date-time":"2026-01-06T00:17:41Z","timestamp":1767658661873,"date-parts":[[2026,1,6]]},"license":[{"URL":"https://doi.org/10.1071/journalslicense","start":{"date-time":"2025-12-10T00:00:00Z","timestamp":1765324800000,"date-parts":[[2025,12,10]]},"delay-in-days":0,"content-version":"vor"}],"subject":[],"abstract":"$31","language":"en","relation":{},"resource":{"primary":{"URL":"https://connectsci.au/py/article/32/1/PY25057/267578/Developing-a-co-designed-triage-support-tool-for"}},"subtitle":[],"deposited":{"date-time":"2026-01-05T23:31:49Z","timestamp":1767655909000,"date-parts":[[2026,1,5]]},"issn-type":[{"type":"print","value":"1448-7527"},{"type":"electronic","value":"1836-7399"}],"published":{"date-parts":[[2026,1,6]]},"publisher":"CSIRO Publishing","reference":[{"DOI":null,"key":"2026010518313987600_R1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":"Agency for Clinical Innovation (NSW Health) (2020) Growing concerns tool for the disability sector: supporting people with intellectual disability when you think they might be unwell. 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