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We read with interest the recent article by Beaton et al on improving triage in upper gastrointestinal bleeding (UGIB).1 A pertinent issue not included in this study is triage and transfer of patients with UGIB from sites without provisions for 24-hour endoscopy to tertiary out-of-hours (OOH) centres. The decision to transfer can be clinically and logistically challenging; hence, many centres use scoring systems to aid decision-making.