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Ethics code: IR.SSU.MEDICINE.REC.1403.289

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Department of Emergency Medicine, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Abstract:   (102 Views)
Artificial intelligence plays a central role in patient triage by enhancing the accuracy and efficiency of ranking care, allowing rapid identification of critically ill patients, reducing under- and over-triaging, and enhancing resource distribution in clinical settings, which eventually improves patient outcomes and reduces delay times. This study aimed to assess and summarize the current evidence on how artificial intelligence (AI), particularly machine learning (ML) models, are used to improve the accuracy of triage and predict patient outcomes in Emergency Departments (EDs). A widespread search was conducted across three major scientific databases, targeting studies published between 2023 and 2024. The search strategy combined keywords related to AI, ML, ED, triage, and patient outcomes. The studies evaluated a broad range of patient variables, including demographic characteristics (age, gender, ethnicity, socioeconomic status), vital signs (heart rate, respiratory rate, blood pressure, oxygen saturation, body temperature), medical history, symptoms, laboratory results, imaging data (CT scans, ECGs, slit lamp images), and emergency visit details. ML and AI models generally enhanced triage accuracy, with some achieving high performance metrics (e.g., 91% AUC and 70% F1 score using Histogram-Based Gradient Boosting classifiers) and effectively predicting critical outcomes, such as intubation need, ICU admission, in-hospital cardiac arrest, and vasopressor administration. ChatGPT showed promise in specialized triage contexts, such as metastatic prostate cancer; however, it had notable under-triage rates in high-acuity groups. AI-assisted imaging significantly improved sensitivity in detecting conditions, such as Inferior Vena Cava Embolism, without loss of specificity. In emergency eye care, AI combined with ocular imaging was beneficial but limited to that specialty. Overall, AI and ML models demonstrated positive impacts on triage efficacy and patient outcome prediction across diverse emergency care settings. These improvements translate into better identification of critically ill patients and more efficient use of ED resources.
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Type of Study: Review | Subject: Emergency Medicine
Received: 2025/05/3 | Accepted: 2025/06/28 | ePublished ahead of print: 2025/08/10

References
1. Lupton JR, Davis-O'Reilly C, Jungbauer RM, Newgard CD, Fallat ME, Brown JB, et al. Under-triage and over-triage using the field triage guidelines for injured patients: a systematic review. Prehosp Emerg Care. 2023;27(1):38-45. [DOI:10.1080/10903127.2022.2043963]
2. Fekonja Z, Kmetec S, Fekonja U, Mlinar Reljić N, Pajnkihar M, Strnad M. Factors contributing to patient safety during triage process in the emergency department: A systematic review. J Clin Nurs. 2023;32(17-18):5461-77. [DOI:10.1111/jocn.16622]
3. Morley C, Unwin M, Peterson GM, Stankovich J, Kinsman L. Emergency department crowding: a systematic review of causes, consequences and solutions. PloS one. 2018;13(8):e0203316. [DOI:10.1371/journal.pone.0203316]
4. Classen DC, Longhurst C, Thomas EJ. Bending the patient safety curve: how much can AI help? NPJ Digit Med. 2023;6(1):2. [DOI:10.1038/s41746-022-00731-5]
5. El Arab RA, Al Moosa OA. The role of AI in emergency department triage: An integrative systematic review. Intensive Crit Care Nurs. 2025;89:104058. [DOI:10.1016/j.iccn.2025.104058]
6. Cascella M, Montomoli J, Bellini V, Bignami E. Evaluating the feasibility of ChatGPT in healthcare: an analysis of multiple clinical and research scenarios. J Med Syst. 2023;47(1):33. [DOI:10.1007/s10916-023-01925-4]
7. Brandao-de-Resende C, Melo M, Lee E, Jindal A, Neo YN, Sanghi P, et al. A machine learning system to optimise triage in an adult ophthalmic emergency department: a model development and validation study. eClinicalMedicine. 2023;66:102331. [DOI:10.1016/j.eclinm.2023.102331]
8. Mutegeki H, Nahabwe A, Nakatumba-Nabende J, Marvin G. Interpretable Machine Learning-Based Triage For Decision Support in Emergency Care2023:983-90. [DOI:10.1109/ICOEI56765.2023.10125918]
9. Hatachi T, Hashizume T, Taniguchi M, Inata Y, Aoki Y, Kawamura A, et al. Machine Learning-Based Prediction of Hospital Admission Among Children in an Emergency Care Center. Pediatr Emerg Care. 2023;39(2):80-6. [DOI:10.1097/PEC.0000000000002648]
10. Choi A, Choi SY, Chung K, Chung HS, Song T, Choi B, et al. Development of a machine learning-based clinical decision support system to predict clinical deterioration in patients visiting the emergency department. Sci Rep. 2023;13(1):8561. [DOI:10.1038/s41598-023-35617-3]
11. Aljubran HJ, Aljubran MJ, AlAwami AM, Aljubran MJ, Alkhalifah MA, Alkhalifah MM, et al. Examining the Use of Machine Learning Algorithms to Enhance the Pediatric Triaging Approach. Open Access Emerg Med. 2025;17:51-61. [DOI:10.2147/OAEM.S494280]
12. Chen J, Wu X, Li M, Liu L, Zhong L, Xiao J, et al. EE-Explorer: A Multimodal Artificial Intelligence System for Eye Emergency Triage and Primary Diagnosis. Am J Ophthalmol. 2023;252:253-64. [DOI:10.1016/j.ajo.2023.04.007]
13. Peng Z, Ma R, Zhang Y, Yan M, Lu J, Cheng Q, et al. Development and evaluation of multimodal AI for diagnosis and triage of ophthalmic diseases using ChatGPT and anterior segment images: protocol for a two-stage cross-sectional study. Front Artif Intell. 2023;6:1323924. [DOI:10.3389/frai.2023.1323924]
14. Gebrael G, Sahu KK, Chigarira B, Tripathi N, Mathew Thomas V, Sayegh N, et al. Enhancing Triage Efficiency and Accuracy in Emergency Rooms for Patients with Metastatic Prostate Cancer: A Retrospective Analysis of Artificial Intelligence-Assisted Triage Using ChatGPT 4.0. Cancers (Basel). 2023;15(14):3717. [DOI:10.3390/cancers15143717]
15. Karlafti E, Anagnostis A, Simou T, Kollatou AS, Paramythiotis D, Kaiafa G, et al. Support Systems of Clinical Decisions in the Triage of the Emergency Department Using Artificial Intelligence: The Efficiency to Support Triage. Acta Med Litu. 2023;30(1):19-25. [DOI:10.15388/Amed.2023.30.1.2]
16. Elhaj H, Achour N, Hoque Tania M, Aciksari K. A comparative study of supervised machine learning approaches to predict patient triage outcomes in hospital emergency departments. Array. 2023;17:100281. [DOI:10.1016/j.array.2023.100281]
17. Savage CH, Elkassem AA, Hamki O, Sturdivant A, Benson D, Grumley S, et al. Prospective Evaluation of Artificial Intelligence Triage of Incidental Pulmonary Emboli on Contrast-Enhanced CT Examinations of the Chest or Abdomen. American Journal of Roentgenology. 2024;223(3):e2431067. [DOI:10.2214/AJR.24.31067]
18. 18. Tortum F, Kasali K. Exploring the potential of artificial intelligence models for triage in the emergency department. Postgrad Med. 2024;136(8):841-6. [DOI:10.1080/00325481.2024.2418806]
19. Menshawi AM, Hassan MM. A novel triage framework for emergency department based on machine learning paradigm. Expert Systems. 2025;42(2):e13735. [DOI:10.1111/exsy.13735]
20. Hinson JS, Taylor RA, Venkatesh A, Steinhart BD, Chmura C, Sangal RB, et al. Accelerated chest pain treatment with artificial intelligence-informed, risk-driven triage. JAMA internal medicine. 2024;184(9):1125-7. [DOI:10.1001/jamainternmed.2024.3219]
21. Paslı S, Şahin AS, Beşer MF, Topçuoğlu H, Yadigaroğlu M, İmamoğlu M. Assessing the precision of artificial intelligence in emergency department triage decisions: Insights from a study with ChatGPT. Am J Emerg Med. 2024;78:170-5. [DOI:10.1016/j.ajem.2024.01.037]
22. Chang P-C, Liu Z-Y, Huang Y-C, Hsu Y-C, Chen J-S, Lin C-H, et al. Machine learning-based prediction of acute mortality in emergency department patients using twelve-lead electrocardiogram. Front Cardiovasc Med. 2023;10:1245614. [DOI:10.3389/fcvm.2023.1245614]
23. Jeon E-T, Song J, Park DW, Lee K-S, Ahn S, Kim JY, et al. Mortality prediction of patients with sepsis in the emergency department using machine learning models: a retrospective cohort study according to the Sepsis-3 definitions. Signa Vitae. 2023;19(5): 112-24.
24. Yaddaden Y, Benahmed Y, Rioux M-D, Kallel M, editors. Machine Learning-Based Pre-Diagnosis Tools in Emergency Departments: Predicting Hospitalization, Mortality and Triage Acuity. 2023 IEEE Third International Conference on Signal, Control and Communication (SCC); 2023:1-6. [DOI:10.1109/SCC59637.2023.10527491]
25. Tschoellitsch T, Seidl P, Böck C, Maletzky A, Moser P, Thumfart S, et al. Using emergency department triage for machine learning-based admission and mortality prediction. Eur J Emerg Med. 2023;30(6):408-16. [DOI:10.1097/MEJ.0000000000001068]
26. Lee S, Kang WS, Kim DW, Seo SH, Kim J, Jeong ST, et al. An artificial intelligence model for predicting trauma mortality among emergency department patients in South Korea: retrospective cohort study. J Med Internet Res. 2023;25:e49283. [DOI:10.2196/49283]
27. Andrade Magalhães ME, Lemes da Silva CV, Monteiro de Oliveira H, Rodrigues de Lima AB, Salum Flores MT, Ferreira Leite I, et al. The Use of Artificial Inteligence in Patient Triage in Emergency Departments: An Integrative Review. Revista de Gestão Social e Ambiental. 2024;18(12):1-12. [DOI:10.24857/rgsa.v18n12-052]
28. Levin S, Toerper M, Hamrock E, Hinson JS, Barnes S, Gardner H, et al. Machine-Learning-Based Electronic Triage More Accurately Differentiates Patients With Respect to Clinical Outcomes Compared With the Emergency Severity Index. Ann Emerg Med. 2018;71(5):565-74. [DOI:10.1016/j.annemergmed.2017.08.005]
29. Jasim AA, Ata O, Salman OH, editors. AI-Driven Triage: A Graph Neural Network Approach for Prehospital Emergency Triage Patients in IoMT-Based Telemedicine Systems. 2024 International Symposium on Electronics and Telecommunications (ISETC); 2024: IEEE. [DOI:10.1109/ISETC63109.2024.10797314]
30. Petersson L, Larsson I, Nygren JM, Nilsen P, Neher M, Reed JE, et al. Challenges to implementing artificial intelligence in healthcare: a qualitative interview study with healthcare leaders in Sweden. BMC Health Serv Res. 2022;22(1):850. [DOI:10.1186/s12913-022-08215-8]
31. Chenais G, Lagarde E, Gil-Jardiné C. Artificial Intelligence in Emergency Medicine: Viewpoint of Current Applications and Foreseeable Opportunities and Challenges. J Med Internet Res. 2023;25:e40031. [DOI:10.2196/40031]
32. Ahmed MI, Spooner B, Isherwood J, Lane M, Orrock E, Dennison A. A Systematic Review of the Barriers to the Implementation of Artificial Intelligence in Healthcare. Cureus. 2023;15(10):e46454. [DOI:10.7759/cureus.46454]

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