Content Validity Assessment of a Newly Developed Emergency Medical Dispatch and Triage Protocol in Thailand.
Journal of clinical medicine · 2025-10-09 · Method & validation
Abstract
Background/Objectives: Accurate telephone triage of emergency medical cases plays a crucial role in improving outcomes for critically ill patients. Effective triage enables emergency medical dispatchers to provide appropriate pre-arrival instructions and to deploy operational units according to the patient's severity level. This study aimed to develop and assess the content validity of the Emergency Medical Triage Protocol and Criteria-Based Dispatch Code (EMTP-CBDC) for Thailand. The objective was to ensure the tool's content accuracy and applicability in prioritizing emergency responses in line with medical urgency, considering global changes and universal standards. Methods: A cross-sectional descriptive study was conducted from 15-30 April 2024. The content validity of the newly developed EMTP-CBDC, comprising 30 symptom groups, was evaluated by five emergency physician experts with at least 1 year of experience in emergency medical oversight. The assessment focused on four aspects: relevance, clarity, simplicity, and ambiguity. The Content Validity Index (CVI) was calculated at both the item level (I-CVI) and the scale level using the average index (S-CVI/Ave). To adjust for chance agreement, the probability of chance agreement (Pc) and the modified kappa coefficient (k*) were calculated for each item. Results: The content validation revealed I-CVI values ranging from 0.80 to 1.00 across all items. The S-CVI/Ave scores were 0.97 for relevance, 0.93 for clarity, 0.98 for simplicity, and 0.94 for ambiguity. These values surpassed the accepted thresholds for content validity. Conclusions: The EMTP-CBDC developed for Thailand demonstrated good content validity across relevance, clarity, simplicity, and ambiguity. Further studies are needed to establish its reliability and field performance before routine implementation.