An interventional study of Case-specific TTAS decision support and Sham triage assistance interface in Triage, sponsored by National Taiwan University Hospital. Not yet recruiting. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-11-13.
Sponsored by National Taiwan University Hospital · Not applicable, Interventional, and Health services research
Help build ClinicalTrials.gg — short surveys, remote interviews or testing, in your language. Take part →
This randomized, three-period crossover study will evaluate a Taiwan Triage and Acuity Scale (TTAS) decision support system in a controlled simulation. Thirty nurses with emergency triage training or experience will each assess three different sets of 50 standardized, de-identified emergency cases. The three study conditions are unassisted triage, case-specific TTAS decision support, and a sham assistance interface. The order of conditions will be randomized, with 7 to 14 days between study periods. The main outcomes are agreement between nurses' final TTAS levels and an expert reference standard, active time needed to assess 50 cases, and a prespecified safety-adjusted efficiency score. Additional outcomes include undertriage, overtriage, workload, usability, and responses to misleading advice. The system will not be used for actual patient triage or entered into clinical records.
The study will develop a traceable TTAS rule knowledge base and evaluate a decision support prototype in simulated emergency triage. A language-processing component identifies candidate complaints, vital signs, and modifiers from standardized case narratives. A deterministic rules engine generates a suggested TTAS level, matched rules, prompts for additional information, and a draft note. Nurses retain final decision authority. Three balanced case sets of 50 de-identified cases will be prepared from retrospective emergency data. At least two experienced emergency physicians or triage nursing experts will independently establish the reference TTAS level; disagreements will be adjudicated by a third blinded expert. Participants will be stratified by clinical experience and site and assigned to one of six condition sequences. Each participant completes all three conditions with different case sets and a 7- to 14-day interval between periods. The sham interface resembles the active interface but provides suggestions that are not based on the individual case, allowing assessment of automation bias. Analysis will account for study condition, period, sequence, case set, participant experience, case acuity, and repeated observations within participants and cases. This is a simulation study; no decision support output is used in care of real patients.
National Taiwan University Hospital is the lead sponsor of 2,617 studies on the registry; 578 are open to participants now.
Of its 11 completed or terminated interventional studies of FDA-regulated products, 2 (18%) have results posted.
Counted across the registry records on this site, refreshed daily.
Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
Exclusion Criteria:
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Informed consent
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Period 1: unassisted triage (A); and then Period 2: active TTAS decision support (B); Period 3: sham assistance (C). Each period includes 50 different standardized cases. Period 2: sham assistance (C); Period 3: active TTAS decision support (B). Each period includes 50 different standardized cases.
Period 1: active TTAS decision support (B); and then Period 2: unassisted triage (A); Period 3: sham assistance (C). Each period includes 50 different standardized cases. Period 2: sham assistance (C); Period 3: unassisted triage (A). Each period includes 50 different standardized cases.
Other: Case-specific TTAS decision support
Period 1: sham assistance (C); and then Period 2: unassisted triage (A); Period 3: active TTAS decision support (B). Each period includes 50 different standardized cases. Period 2: active TTAS decision support (B); Period 3: unassisted triage (A). Each period includes 50 different standardized cases.
Other: Sham triage assistance interface
During review of 50 standardized cases, a research-only interface displays candidate presenting complaints, matched TTAS rules, a suggested triage level, prompts for missing information, and a draft triage note. The nurse makes the final decision.
During review of 50 standardized cases, an interface resembling the active system displays non-case-specific or distribution-matched suggestions. These suggestions are for simulation only and are not used in patient care.
Exact agreement with expert TTAS reference standard
Percentage of completed case assessments for which the nurse's final five-level TTAS assignment exactly matches the adjudicated expert reference level, evaluated separately under each condition.
Time frame: During each of three approximately 60-minute study periods, separated by 7-14 days; up to approximately 4 weeks per participant.
Active time to complete 50 case assessments
Total active time in minutes required to complete the 50-case set in each condition, excluding recorded breaks and system interruptions. The analysis of incomplete sets must be specified before enrollment.
Time frame: During each of three approximately 60-minute study periods, separated by 7-14 days; up to approximately 4 weeks per participant.
Safety-Adjusted Efficiency Score
Prespecified score combining TTAS accuracy and speed. The approved protocol assigns 1.0 for exact agreement, 0.8 or 0.6 for overtriage by one or two levels, 0.4 for undertriage by one level, and 0 for undertriage by two or more levels, with additional penalties for undertriage of Level 1-2 cases. The exact high-acuity penalty, time component, aggregation, score range, and handling of missing cases require final specification before submission.
Time frame: During each of three approximately 60-minute study periods, separated by 7-14 days; up to approximately 4 weeks per participant.
Sensitivity for high-acuity cases (TTAS Levels 1-2)
Proportion of expert-reference Level 1-2 cases assigned Level 1 or 2 by the nurse under each condition.
Time frame: During each of three approximately 60-minute study periods, separated by 7-14 days; up to approximately 4 weeks per participant.
Undertriage rate
Percentage of completed case assessments in which the nurse's final TTAS level indicates lower urgency than the expert reference standard; severe undertriage will be reported separately according to the prespecified threshold.
Time frame: During each of three approximately 60-minute study periods, separated by 7-14 days; up to approximately 4 weeks per participant.
Overtriage rate
Percentage of completed case assessments in which the nurse's final TTAS level indicates higher urgency than the expert reference standard.
Time frame: During each of three approximately 60-minute study periods, separated by 7-14 days; up to approximately 4 weeks per participant.
Acceptance of incorrect suggestions in the sham condition
Percentage of sham-assisted cases in which an incorrect displayed recommendation is accepted in the nurse's final TTAS decision; denominator and incorrectness criteria to be prespecified.
Time frame: During each of three approximately 60-minute study periods, separated by 7-14 days; up to approximately 4 weeks per participant.
No study locations are listed for this record.
Plan to share: No
No publications or documents are linked to this record.
Start is estimated for Jan 2027; primary completion for Dec 2027, 11 months later.
How these figures are worked out, and which studies are left out of them.
From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗
This study is not yet recruiting, as verified in Oct 2026. You cannot join it, but the record below documents what was studied.
Get an email when the registry record changes — status, dates, results — or when someone posts here.
Sign in to followQuestions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.
Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.
Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.
National Taiwan University Hospital →