Abstract
The purpose of triage is to prevent the delay of treatment for patients in real emergencies due to excessive numbers of patients in the hospital. This study uses the data of patients of consistent triage to develop the triage prediction model. By integrating Principal Component Analysis (PCA) and Support Vector Machine (SVM), the anomaly detection (overestimate and underestimate) prediction accuracy rate can be 100 %, which is better than the accuracy rate of SVM (about 89.2 %) or Back- propagation Neural Networks (BPNN) (96.71 %); afterwards, this study uses Support Vector Regression (SVR) to adopt Genetic Algorithm (GA) to determine three SVR parameters to predict triage. After using the scroll data predictive values, we calculate the Absolute Percentage Error (APE) of each scroll data. The resulting SVR’s Mean Absolute Percentage Error (MAPE) is 3.78 %, and BPNN’s MAPE is 5.99 %; therefore, the proposed triage prediction model of this study can effectively predict anomaly detection and triage.

Similar content being viewed by others
References
Cheng, A. P., A discussion on the implications and measurement indicators of pre-hospital emergency medical care service quality for the fire department. Cent Police Univ Police Stud Ser 34(5):155–184, 2004.
Yeh, S. Y., Bullard, M. J., and Hu, P. M., An evaluation of the Taiwan triage scale in a regional hospital. J Emerg Crit Care 19(3):102–112, 2008.
Goransson, K. E., Ehrenberg, A., and Ehnfors, M., Triage in emergency departments: National survey. J Clin Nurs 14:1067–1074, 2005.
Semenza, J. C., Are electronic emergency department data predictive of heat-related mortality? J Med Syst 23(5):419–421, 1999.
Kolker, A., Process modeling of emergency department patient flow: Effect of patient length of stay on ED diversion. J Med Syst 32(5):389–401, 2008.
Department of Health, Executive Yuan, ROC (2010) Adult Triage Scale, Department of Health, Executive Yuan website.
Campo, T., McNulty, R., Sabatini, M., and Fitzpatrick, J., Nurse practitioners performing procedures with confidence and independence in the emergency care setting. Adv Emerg Nurs J 30(2):153–170, 2008.
Carter, A. J., and Chochino, A. H., A systematic review of the impact of nurse practitioners on cost, quality of care, satisfaction and wait times in the emergency department. Can J Emerg Med 9(4):286–295, 2007.
Considine, J., Martin, R., Smit, D., Jenkins, J., and Winter, C., Defining the scope of practice of the emergency nurse practitioner role in a metropolitan emergency department. Int J Nurs Pract 12:205–213, 2006.
Curren, J., Nurse practitioners and physician assistants: Do you know the difference? Medsurge Nurs 16(6):404–407, 2007.
McGee, L. A., and Kaplan, L., Factors influencing the decision to use nurse practitioners in the emergency department. J Emerg Nurs 33(5):441–446, 2007.
Lee, C. H., Kuan, J. T., Chiu, T. F., Szu, L. Y., Chen, L. C., Chen, J. C., and Ng, C. J., Coverage and appropriateness of the Taiwan adult triage complaint list. J Taiw Emerg Med 9:65–71, 2007.
Li, X., Ye, N., Xu, X., and Sawhey, R., Influencing factors of job waiting time variance on a single machine. Eur J Ind Eng 1(1):56–73, 2007.
Steiner, I. P., Nichols, D. N., Blitz, S., Tapper, L., Stagg, A. P., Sharma, L., and Policicchio, C., Impact of a nurse practitioner on patient care in a Canadian emergency department. Can J Emerg Med 11(3):207–214, 2009.
Song, W. T., Chih, M., and Bair, A. E., Improving the efficiency of physical examination services. J Med Syst 34(4):579–590, 2010.
Su, C. T., Wang, P. C., Chen, Y. C., and Chen, L. F., Data mining techniques for assisting the diagnosis of pressure ulcer development in surgical patients. J Med Syst 36(4):2387–2399, 2012.
Wei, C. K., Su, S., and Yang, M. C., Application of data mining on the development of a disease distribution map of screened community residents of Taipei County in Taiwan. J Med Syst 36(3):2021–2027, 2012.
Cheng, C. H., Chou, C. J., Wang, P. C., Lin, H. Y., Kao, C. L., and Su, C. T., Applying HFMEA to prevent chemotherapy errors. J Med Syst 36(3):1543–1551, 2012.
Chen, T., and Wang, Y. C., An evolving hybrid neural approach for predicting job completion time in a semiconductor fabrication plant. Eur J Ind Eng 4(3):336–354, 2010.
Ghose, D. K., Panda, S. S., and Swain, P. C., Prediction of water table depth in western region, Orissa using BPNN and RBFN neural networks. J Hydro 394:296–304, 2010.
Orrù, G., Using support vector machine to identify imaging biomarkers of neurological and psychiatric disease: a critical review. Neurosci Biobehav R 36(4):1140–1152, 2012.
Chang, C. Y., Chen, S. J., and Tsai, M. F., Application of support-vector-machine-based method for feature selection and classification of thyroid nodules in ultrasound images. Pattern Recogn 43:3494–3506, 2010.
Huang, M. L., and Chen, H. Y., Development and comparison of automated classifiers for glaucoma diagnosis using stratus optical coherence tomography. Invest Ophth Visual 46(11):4121–4129, 2005.
Sharda, R., and Delen, D., Predicting box-office success of motion pictures with neural networks. Expert Syst Appl 30(2):243–254, 2006.
Abdolmaleki, P., Buadu, L. D., and Naderimansh, H., Feature extraction and classification of breast cancer on dynamic magnetic resonance imaging using artificial neural network. Cancer Lett 171(2):183–191, 2001.
Jiang, H., and He, W., Grey relational grade in local support vector regression for financial time series prediction. Expert Syst Appl 39(3):2256–2262, 2011.
Hu, H. Y., Lee, Y. C., Yen, T. M., and Tsai, C. H., Using BPNN and DEMATEL to modify importance–performance analysis model–a study of the computer industry. Expert Syst Appl 36(6):9969–9979, 2009.
Li, G., Lau, J. T., McCarthy, M. L., Schull, M. J., and Kelen, G. D., Emergency department utilization in the united states and Ontario, Canada. Acad Emerg Med 14(6):582–584, 2007.
Yang, L. N., Peng, L., Zhang, L. M., Zang, L. L., and Yang, S. S., A prediction model for population occurrence of paddy stem borer (Scirpophaga incertulas), based on back propagation artificial neural network and principal components analysis. Comput Electron Agr 68(2):200–206, 2009.
Lloyd, C. D., Analyzing population characteristics using geographically weighted principal components analysis: a case study of Northern Ireland in 2001. Environ Urban Syst 34(5):389–399, 2010.
Wu, T. K., Huang, S. C., and Meng, Y. R., Evaluation of ANN and SVM classifiers as predictors to the diagnosis of students with learning disabilities. Expert Syst Appl 34(3):1846–1856, 2008.
Lu, C. J., Lee, T. S., and Chiu, C. C., Financial time series forecasting using independent component analysis and support vector regression. Decis Support Syst 47(2):115–125, 2009.
Vapnik, V., The nature of statistical learning theory. Springer, New York, 2000.
Conflict of Interest
The author declare that I have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Wang, ST. Construct an Optimal Triage Prediction Model: A Case Study of the Emergency Department of a Teaching Hospital in Taiwan. J Med Syst 37, 9968 (2013). https://doi.org/10.1007/s10916-013-9968-x
Received:
Accepted:
Published:
DOI: https://doi.org/10.1007/s10916-013-9968-x