Concentrated work is clearly required to amend and validate existing scoring systems so that they are suitable for use as triage tools. We suggest that this should be done on two levels. While disease specific scoring systems are valuable and should continue to be refined, there is a need to develop an appropriately generalisable scoring system for as unselected a group of patients as possible. To have the discriminating power, it will need to take place on a multicentre or, preferably, on a multi-national basis.