Emergency Medical Services dispatcher recognition of stroke: A systematic review.

IF 5.8 3区 医学 Q1 CLINICAL NEUROLOGY European Stroke Journal Pub Date : 2024-06-01 Epub Date: 2024-01-04 DOI:10.1177/23969873231223339
Jonathan Wenstrup, Bartal Hofgaard Hestoy, Malini Vendela Sagar, Stig Nikolaj Fasmer Blomberg, Hanne Christensen, Helle Collatz Christensen, Christina Kruuse
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Abstract

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.

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紧急医疗服务调度员对中风的识别:系统综述。
目的:脑卒中治疗具有时间敏感性,因此急救医疗服务对脑卒中的早期正确识别对治疗效果至关重要。这一点在移动卒中单元的应用中尤为重要。因此,在本系统综述中,我们旨在全面概述紧急医疗服务调度员对中风的识别:本综述在 PROSPERO 上注册,并采用了 PRISMA 指南。我们检索了 PubMed、Embase 和 Cochrane Review Library。筛选和数据提取由两名观察员完成。使用 QUADAS-2 工具评估偏倚风险:在筛选出的 1200 篇论文中,有 24 篇符合纳入标准。22篇论文报告了灵敏度数据,灵敏度从17.9%到83.0%不等。12 篇论文报告了阳性预测值,从 24.0% 到 87.7% 不等。7 篇论文报告了特异性,范围从 20.0% 到 99.1%。6 篇论文报告了阴性预测值,范围从 28.0% 到 99.4%。总体而言,偏倚风险较低:讨论:调度员对脑卒中的识别能力差异很大,但总体而言,尽管采取了提高脑卒中知识普及率的措施,许多脑卒中患者仍未被识别。现有数据质量较高,但亚洲、非洲和南美洲人群的代表性不足:尽管数据不尽相同,但本综述可作为今后研究急救调度员卒中识别能力和提高院前卒中识别能力的参考。
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来源期刊
CiteScore
7.50
自引率
6.60%
发文量
102
期刊介绍: Launched in 2016 the European Stroke Journal (ESJ) is the official journal of the European Stroke Organisation (ESO), a professional non-profit organization with over 1,400 individual members, and affiliations to numerous related national and international societies. ESJ covers clinical stroke research from all fields, including clinical trials, epidemiology, primary and secondary prevention, diagnosis, acute and post-acute management, guidelines, translation of experimental findings into clinical practice, rehabilitation, organisation of stroke care, and societal impact. It is open to authors from all relevant medical and health professions. Article types include review articles, original research, protocols, guidelines, editorials and letters to the Editor. Through ESJ, authors and researchers have gained a new platform for the rapid and professional publication of peer reviewed scientific material of the highest standards; publication in ESJ is highly competitive. The journal and its editorial team has developed excellent cooperation with sister organisations such as the World Stroke Organisation and the International Journal of Stroke, and the American Heart Organization/American Stroke Association and the journal Stroke. ESJ is fully peer-reviewed and is a member of the Committee on Publication Ethics (COPE). Issues are published 4 times a year (March, June, September and December) and articles are published OnlineFirst prior to issue publication.
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