A foundational triage system for improving accuracy in moderate acuity level emergency classifications.

Background: Triage is an essential part of Emergency Medicine, which may be assisted by AI models due to limited availability of medical staff. However, AI models for aiding triage have difficulty in identifying levels that are difficult or ambiguous for human clinicians to distinguish. This study aims to develop a more reliable triage model that improves the accuracy of classification, especially for cases with moderate acuity.

Methods: We developed a new triage model called KUTS, a foundational classification model for emergency triage, which leverages a knowledge prompt-tuning encoder and an uncertainty-based classifier. KUTS takes tabular data and chief complaints as input, and then assign different acuity levels to patients based on their condition acuity. We trained and tested the model on multiple real-world emergency department datasets.

Results: Here we show that on the most difficult level for human to distinguish (moderate acuity level), our KUTS substantially outperforms the previous shallow single-modal methods, deep single-modal methods and deep multi-modal methods on AUC score, by an average of 0.19, 0.35, and 0.13 (from 0.76, 0.60, 0.82 to 0.95), respectively. Besides, on all the triage levels, our KUTS also outperforms the previous shallow single-modal methods, deep single-modal methods and deep multi-modal methods on AUC score, by an average of 0.14, 0.20 and 0.06 (from 0.82, 0.76, 0.90 to 0.96), respectively.

Conclusions: KUTS provides a foundational framework and paradigm for the study of emergency triage, and facilitates the development of more efficient triage systems.