Staff Publication

Accuracy and Timeliness of Prehospital Global Triage System Protocols in Mass Disasters: A Systematic Review of Systematic Reviews (2025)

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Type of publication:

Systematic Review

Author(s):

Shaltout, Amr Essam; Elfatih Elbadri, Mohammed; Kaur, Kiranjot; Alsharif, Mohammed M; Alkhazendar, Aliaa H; *Hassouba, Omar Nasr; Ahmad, Muhammad Nabeel; Osman, Mazin; Zahid, Areeba; Banjamin, Shaun.

Citation:

Cureus. 17(9):e92796, 2025 Sep.

Abstract:

This systematic review evaluated the accuracy and timeliness of global prehospital triage systems in mass disasters, following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020
guidelines. A comprehensive search of PubMed/MEDLINE, Embase, Scopus, and Cochrane Library up to June 2025 identified 344 records, of which four studies met eligibility criteria after screening and full-text assessment. Included studies analyzed conventional systems such as Simple Triage and Rapid Treatment (START), JumpSTART, Sort, Assess, Lifesaving Interventions, Treatment/Transport (SALT), and Modified Physiological Triage Tool (MPTT), as well as artificial intelligence (AI)-assisted approaches and diagnostic adjuncts like portable ultrasound. Sample sizes ranged from targeted reviews of 30-60 studies (systematic and evidence-based reviews) to practical evaluations of triage innovations involving prehospital and emergency responders. Data extraction captured accuracy, timeliness, and resource allocation, while risk of bias was assessed using the A Measurement Tool to Assess Systematic Reviews version 2 (AMSTAR-2) and the Scale for the Assessment of Narrative Review Articles (SANRA), with ratings ranging from low to moderate. Results demonstrated that traditional systems such as START and SALT provide rapid categorization but remain prone to over- and under-triage depending on responder training and situational factors. AI-driven models and portable diagnostic technologies significantly improved decision speed, diagnostic precision, and prioritization of life-saving interventions, reducing delays in critical care. Overall, while no single algorithm proved universally superior, integration of training, simulation-based preparedness, and emerging AI-supported tools was consistently associated with improved triage performance in chaotic, resource-limited disaster environments.

DOI: 10.7759/cureus.92796

Link to full-text [open access - no password required]

Microvascular Outcomes of Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists in Type 2 Diabetes: A Systematic Review of Retinopathy and Nephropathy Evidence (2025)

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Type of publication:

Systematic Review

Author(s):

Arif, Atia; Lama, Sanu; Singla, Bhavna; Singla, Shivam; Kumawat, Sunita; Tharwani, Anusha; Usman, Muhammad; Khalid, Hamna; Kanukollu, Venkata Madusudana Rao; *Ekomwereren, Osatohanmwen; Khan, Shabir.

Citation:

Cureus. 17(9):e92976, 2025 Sep.

Abstract:

This systematic review evaluated randomized controlled trials examining the effects of glucagon-like peptide-1 (GLP-1) receptor agonists on microvascular outcomes in type 2 diabetes, focusing on diabetic retinopathy and nephropathy. Four eligible RCTs, enrolling over 27,000 patients with follow-up periods ranging from 32 weeks to 5.4 years, were included. GLP-1 receptor agonists consistently demonstrated renal protective effects, primarily driven by reductions in new or worsening nephropathy and acroalbuminuria, with more modest and inconsistent effects on estimated glomerular filtration rate (eGFR) decline. In contrast, their impact on retinopathy remained inconclusive. A transient signal of worsening retinopathy has been reported in the context of rapid glycemic improvement; however, across large outcome trials, effects on retinopathy have been inconsistent and remain inconclusive. Overall, the evidence for retinopathy risk is limited by small event numbers, heterogeneity in assessments, and exploratory analyses. The certainty of renal benefit was strengthened by rigorous trial designs and low risk of bias, whereas retinopathy outcomes were generally secondary and less robust. These findings suggest that GLP-1 receptor agonists can be prioritized for patients at high renal risk, but careful monitoring of individuals with pre-existing retinopathy remains warranted

DOI: 10.7759/cureus.92976

Link to full-text [open access - no password required]

Transport – Test of Change (2025)

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Type of publication:

Service improvement case study

Author(s):

*S. Fenton-Cook; *L. Brewin

Citation:

SaTH Improvement Hub, September 2025

SMART Aim:

During the week of 14th July 2025 improve patient flow, reduce failed discharges due to transport delays, improve end of day position and reduce risk of escalation in areas that normally remain closed.

Link to PDF poster

Improving Orthodontics and Oral Surgery pathway: Part 2 – Patient pathway redesign (2025)

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Type of publication:

Service improvement case study

Author(s):

*Leonie Seager

Citation:

SaTH Improvement Hub, September 2025

SMART Aim:

To reduce the overall time of orthodontic patients waiting for oral surgery following an orthodontic referral to 52 weeks by July 2025. To reduce the waiting time of patients from referral to OMFS to TCI
(being added to the oral surgery waiting list) to 3 months by July 2025.

Link to PDF poster

Increasing productivity & workflow within the ward office of Ward 32 (2025)

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Type of publication:

Service improvement case study

Author(s):

*Danyal Fiaz

Citation:

SaTH Improvement Hub, August 2025

SMART Aim:

To improve ward office productivity by increasing staff reporting the space as suitable for meetings from 0% to at least 60%, and those able to access all necessary shift documents from 50% to 100%, by 20th July 2025.

Link to PDF poster

Mental Health Liaison Team (2025)

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Type of publication:

Service improvement case study

Author(s):

*Gemma Styles (on behalf of the working group)

Citation:

SaTH Improvement Hub, August 2025

SMART Aim:

To bridge the gap between physical and mental health care in PRH ED by June 2025, as evidenced by robust triage documentation and early referral to the mental health liaison service.

Link to PDF poster

Elective Hub High Flow List- Gynae (2025)

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Type of publication:

Service improvement case study

Author(s):

*Martyn Underwood

Citation:

SaTH Improvement Hub, July 2025

SMART Aim:

To increase utilisation on an all day theatre list on the 16th of July 2025. Sub aim: To increase number of cases on an all day theatre list by 1 on the 16th of July 2025.

Link to PDF poster