Triage of acute abdominal pain in childhood: clinical use of a palm handheld in a pediatric emergency department

The paper describes design and implementation of a mobile clinical triage support system for the evaluation of acute appendicitis in childhood. The MET (mobile emergency triage) system was developed according to the general principles of client server architecture, with mobile clients running on palm handhelds. Decision model implemented in MET follows the principles of evidence based medicine based on retrospective data. We applied a hybrid methodological approach involving fuzzy measures and rough set theory to develop this model. In a randomized retrospective trial, the triage recommendation of the MET system had a sensitivity of 86.7% and a specificity of 85.7%. MET is a fully functional mobile clinical triage support system that provides triage recommendation at the point of care, irrespective of the completeness of the clinical information. It also allows for data capture and interaction with the hospital´s information system. Given mobility of MET and its easy to use features, we are proposing a system that can both support evidence based emergency room patient care, and at the same time, streamline the bedside triage of a child with abdominal pain.