The Role of Language in Remote Healthcare Triage: A Meta-Aggregative Review.
Michelle Spek, Marije van Braak, Daphne C A Erkelens and 4 others
PMID 39382340WHAT IT FOUND
Remote triage calls are not just checklist questions.
Call-takers and dispatch software shape turn-taking, question wording, and whether caller concerns are heard. Some wording choices can hide urgency, so listening and checking understanding matter.
Key findings
01Call-takers usually lead remote triage conversations, taking more turns, setting the agenda, and inviting callers to expand rather than letting callers take the floor.
02Computerised decision support strongly shapes triage structure and question design, and nurse-led CDSS triage can become checklist-style, risking that the caller's own explanation is missed.
03A qualified yes answer, such as yes plus severe discomfort or new symptoms, may indicate more urgency than a plain yes and needs careful checking.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review synthesised qualitative and conversation-analytic studies, not trials, so it does not prove that changing wording improves triage accuracy. Included studies varied widely in setting, language, method, and call type, so findings may not transfer to every telephone triage system. No formal quality appraisal tool was used because the included methods did not fit standard appraisal frameworks. Many included studies had small, context-specific samples, and direct links between language features and urgency determination were not consistently measured. The search was limited to English or Dutch, and studies that only described experiences in interviews were largely excluded unless language was analysed in detail.
Declared interests
The authors declare no conflicts of interest. The funder is named as ZonMw.
The easy way to misread this
Do not read the suggested question changes as evidence that they improve triage accuracy. The review describes interaction patterns and flags possible risks, but it did not test a communication intervention, and several linguistic measures did not distinguish urgent from non-urgent calls.