Triage in de huisartsenpraktijk: te zwaar geschut?

Based on triage during out-of-hours emergency services with physical contact with patients, the Dutch Triage Standard - a telephone triage algorithm - has been developed for use in primary care out-of-hours services. However, it is also used in the daytime setting. We argue that this tool should be evaluated by actually evaluating the telephone contacts that are backed up during triage and using the final diagnoses of these contacts as the reference standard. We have serious doubts whether the Dutch Triage Standard is an effective tool in the primary care daytime setting with its very low prevalence of high urgency. Adequate triage is time consuming, and may result in reduced accessibility thus creating critical situations. Well-evaluated pilots should precede large-scale implementation of decision support systems.