Developing a national triage tool for use in NHS regional trauma networks: the MATTS mixed methods study.

Systematic reviewHealth technology assessment (Winchester, England)· May 2026

Developing a national triage tool for use in NHS regional trauma networks: the MATTS mixed methods study.

Gordon W Fuller, James Baird, Joshua Miller … MATTS research group

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Prehospital & RetrievalSystematic reviewQ1IF 2.6

New national trauma triage tool correctly ruled out 94.3% of non-major-trauma patients.

Developing a national triage tool for use in NHS regional trauma networks: the MATTS mixed methods study.

Gordon W Fuller … MATTS research group

Health technology assessment (Winchester, England) · May 2026 · Q1 in General Medicine

Background

There is currently wide variation in prehospital major trauma triage across the National Health Service, with regional ambulance services using different triage tools, varying in format, structure and variables.

Purpose

To develop a national triage tool that is acceptable, usable, accurate, and optimises under- and over-triage.

Methods

English regional trauma networks served by the South-Western, West Midlands, Yorkshire and London Ambulance Services.

n = 2757 patients

Results

correctly identified as not major trauma, minimizing overtriage

37.3%

Sensitivity

95.1%

Specificity

More results

Following review of Phase 1 evidence, a three-step Major Trauma Triage Study candidate triage tool targeting relatively higher specificity was developed through expert consensus.

The Phase 2 case-cohort sample included 2757 patients, with a weighted prevalence of major trauma of 3.1% (95% confidence interval 2.3% to 4.0%).

More results

The Major Trauma Triage Study tool performed optimally compared to under- and over-triage targets (sensitivity 37.3%, specificity 95.1%).

Minimal differences were apparent between the costs (£149) and benefits (0.006 quality-adjusted life-years) of triage decisions, regardless of the triage tool used, reflecting similar real-life triage accuracy.

“

Conclusion · 1 of 3

The Major Trauma Triage Study triage tool performed optimally, targeted an appropriate under-/over-triage trade-off, and was perceived to perform well by stakeholders.

Conclusion · 2 of 3

National implementation could ensure evidence-based, standardised and cost-effective triage.

Conclusion · 3 of 3

LIMITATIONS: Significant variation in National Health Service ambulance service and trauma network configurations could limit the generalisability of results.

Developing a national triage tool for use in NHS regional trauma networks: the MATTS mixed methods study.

Developing a national triage tool for use in NHS regional trauma networks: the MATTS mixed methods study.

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