TY - JOUR

T1 - Emergency Medical Services dispatcher recognition of stroke

T2 - A systematic review

AU - Wenstrup, Jonathan

AU - Hestoy, Bartal Hofgaard

AU - Sagar, Malini Vendela

AU - Blomberg, Stig Nikolaj Fasmer

AU - Christensen, Hanne

AU - Christensen, Helle Collatz

AU - Kruuse, Christina

N1 - Publisher Copyright: © European Stroke Organisation 2024.

PY - 2024

Y1 - 2024

N2 - Purpose: Stroke treatments are time-sensitive, and thus early and correct recognition of stroke by Emergency Medical Services is essential for outcomes. This is particularly important with the adaption of mobile stroke units. In this systematic review, we therefore aimed to provide a comprehensive overview of Emergency Medical Services dispatcher recognition of stroke. Methods: The review was registered on PROSPERO and the PRISMA guidelines were applied. We searched PubMed, Embase, and Cochrane Review Library. Screening and data extraction were performed by two observers. Risk of bias was assessed using the QUADAS-2 instrument. Findings: Of 1200 papers screened, 24 fulfilled the inclusion criteria. Data on sensitivity was reported in 22 papers and varied from 17.9% to 83.0%. Positive predictive values were reported in 12 papers and ranged from 24.0% to 87.7%. Seven papers reported specificity, which ranged from 20.0% to 99.1%. Six papers reported negative predictive value, ranging from 28.0% to 99.4%. In general, the risk of bias was low. Discussion: Stroke recognition by dispatchers varied greatly, but overall many patients with stroke are not recognised, despite the initiatives taken to improve stroke literacy. The available data are of high quality, however Asian, African, and South American populations are underrepresented. Conclusion: While the data are heterogenous, this review can serve as a reference for future research in emergency medical dispatcher stroke recognition and initiatives to improve prehospital stroke recognition.

AB - Purpose: Stroke treatments are time-sensitive, and thus early and correct recognition of stroke by Emergency Medical Services is essential for outcomes. This is particularly important with the adaption of mobile stroke units. In this systematic review, we therefore aimed to provide a comprehensive overview of Emergency Medical Services dispatcher recognition of stroke. Methods: The review was registered on PROSPERO and the PRISMA guidelines were applied. We searched PubMed, Embase, and Cochrane Review Library. Screening and data extraction were performed by two observers. Risk of bias was assessed using the QUADAS-2 instrument. Findings: Of 1200 papers screened, 24 fulfilled the inclusion criteria. Data on sensitivity was reported in 22 papers and varied from 17.9% to 83.0%. Positive predictive values were reported in 12 papers and ranged from 24.0% to 87.7%. Seven papers reported specificity, which ranged from 20.0% to 99.1%. Six papers reported negative predictive value, ranging from 28.0% to 99.4%. In general, the risk of bias was low. Discussion: Stroke recognition by dispatchers varied greatly, but overall many patients with stroke are not recognised, despite the initiatives taken to improve stroke literacy. The available data are of high quality, however Asian, African, and South American populations are underrepresented. Conclusion: While the data are heterogenous, this review can serve as a reference for future research in emergency medical dispatcher stroke recognition and initiatives to improve prehospital stroke recognition.

KW - acute ischaemic infarction

KW - emergency medical services

KW - out-of-hours health service

KW - Stroke

KW - systematic review

KW - transient ischaemic attack

U2 - 10.1177/23969873231223339

DO - 10.1177/23969873231223339

M3 - Review

C2 - 38174575

AN - SCOPUS:85181436532

JO - European Stroke Journal

JF - European Stroke Journal

SN - 2396-9873

ER -