Background
Methods
Search strategy
PubMed | |
1 | (medical[all fields] AND dispatch*[all fields]) OR (emergency[all fields] AND dispatch*[all fields]) OR “Emergency Medical Dispatch”[all fields] OR dispatch centres[all fields] |
2 | triage[all fields] |
3 | Criteria based[all fields] |
4 | Physician based[all fields] |
5 | “emergency medicine” [all fields] |
6 | 2 OR 3 OR 4 OR 5 |
7 | 1 AND 6 |
8 | English, year> = 2012 |
Web of Science (Indexes = SCI-EXPANDED, SSCI, A&HCI, ESCI Timespan = All years) | |
1 | Topic = (Emergency OR Medical OR centres) AND Dispatch* |
2 | Topic = triage |
3 | Topic = criteria based |
4 | Topic = physician based |
5 | Topic “emergency medicine” |
6 | 2 OR 3 OR 4 OR 5 |
7 | 1 AND 6 |
8 | 7 AND English, year > = 2012, Article, Review |
Embase (free text in all fields) | |
1 | (emergency OR medical OR centres) AND dispatch* |
2 | Triage |
3 | criteria based |
4 | physician based |
5 | “emergency medicine” |
6 | 2 OR 3 OR 4 OR 5 |
7 | 1 AND 6 |
8 | 7 AND English, year > = 2012, article, review, article in press |
CRD - Centre for Reviews and Dissemination, York | |
1 | Dispatch*, english, year > = 2012 |
Cochrane | |
1 | (emergency OR medical OR centres) AND dispatch* |
2 | Triage OR criteria OR physician OR “emergency medicine” |
3 | 1 AND 2 |
4 | 3 AND english, year > = 2012, NOT conference |
Inclusion- and exclusion criteria
Title and abstract screening
Full text screening for relevance
Level of evidence according to GRADE
Measurement of inter-rater agreement
Results
Study selection
Inter-rater agreement
Characteristics of included articles
First author (year of publication) | Design | GRADE Rating | Area and/or Country of publication | Population | Number of patients/incidents | Dispatching system category | Additional information |
---|---|---|---|---|---|---|---|
Clawson J. J. et al. (2016) [25]. | Retrospective descriptive | Very low | Salt Lake City, USA | EMD identified strokes | 4712 hospital confirmed strokes | Medical Priority Dispatch System | Final inhospital diagnosis as stroke was reference |
Dami F. et al. (2017) [22]. | Retrospective observational | Very low | Region of Vaud, Switzerland | Identification of acute stroke, onset within 5 h | 427 patients | Criteria Based Dispatch | Final inhospital diagnosis as stroke was reference |
Malekzadeh J. et al. (2015) [24]. | “Quasi empirical design” | Moderate | Mashhad, Iran | Suspected stroke among callers | 246 patients | CPSS vs. “Regional system” | Final inhospital diagnosis as stroke was reference |
Krebes S. et al. (2012) [26]. | Retrospective observational | Low | Berlin, Germany | Emergency calls due to stroke | 207 patients | MPDS with a new developed algorithm | Final inhospital diagnosis as stroke was reference |
Viereck S. et al. (2016) [23]. | Retrospective observational | Very low | EMS Copenhagen | Emergency calls due to stroke | 2653 patients | Criteria Based Dispatch | Final inhospital diagnosis as stroke/TIA was reference |
Deakin C. D. et al. (2017) [17]. | Retrospective observational | Very low | United Kingdom | Emergency calls due to CA, adult | 469,400/8830 emergency calls, adult | NHS Pathways | Using ambulance crew’s decision as reference |
Moller T. P. et al. (2016) [18]. | Retrospective observational | Very low | Denmark and Sweden | Patients from national cardiac arrest registers and connected emergency calls | 776 patients from Denmark and 346 from Sweden | Criteria Based Dispatch | The information from the ambulance crew (cardiac arrest register) was reference |
Fukushima H. et al. (2015) [19]. | Before/after comparison | Very low | Japan | Patients from national cardiac arrest register and connected emergency calls | 478 patients (before) and 427 (after) | “Regional system” | The information from the ambulance crew (cardiac arrest register) was reference |
Tanaka Y. et al. (2014) [20]. | Prospective observational | Very low | Japan | Emergency calls due to CA and connected ambulance records | 2747 emergency calls with dispatcher-assisted cardiopulmonary resuscitation attempt | “Regional system” | The information from the fire department crew (cardiac arrest register) was reference |
Vaillancourt C. et al. (2015) [16]. | Retrospective observational | Very low | Canada | Emergency calls due to CA | 2260/1536 emergency calls | DPCI | The information from the ambulance crew (cardiac arrest register) was reference |
Gellerstedt M. et al. (2016) [21]. | Retrospective observational | Low | Vätragötland, Sweden | Emergency calls due to chest pain | 2285 consecutive patients dialed 112 with chest pain | Criteria Based Dispatch | Inhospital diagnosis as acute coronary syndrome was reference |
Giannakopoulos G. F. et al. (2012) [15]. | Retrospective | Very low | Netherlands | Trauma-related dispatch | 420 trauma patients | Based on MOI | Identification of major trauma due to definitions |
Wilmer I. et al. (2015) [27]. | Retrospective observational | Low | London’s Air Ambulance | Major trauma | 2203 helicopter activations | Closest to CBD, but there is no formal protocol | Identification of patients with serious injury due to definitions |
Ball S. J. et al. (2016) [28]. | Retrospective observational | Low | Australia, Perth Western Australia | Consecutive cases of ambulance dispatch | 211,473 consecutive cases of ambualnce dispatch, “whole of population study” | Medical Priority Dispatch System | Time critical condition by paramedic-determined patient condition at the time of departing the scene was used as reference |
Dami F. et al. (2015) [13]. | Retrospective observational | Very low | Switzerland | Primary missions | 29,008 ambulance missions | Criteria Based Dispatch | The severity of cases assessed by paramedics on site using the NACA-score was reference |
Ek B. et al. (2013) [29]. | Retrospective | Very low | Jämtland, Sweden | Consecutive cases of medical dispatch | 4835 ambulance dispatches | Criteria Based Dispatch | METTS-A according to ambulance was reference |
Leopardi M. and Sommacampagna M (2013) [30]. | Retrospective observational | Very low | Italy | Emergency calls | 53,606 emergency calls | “Regional system” | The sensitivity of subjective experience-based nurse dispatch in detecting the need for phycisian interventions |
Moser A. et al. (2017) [14]. | Before/after comparison | Very low | Switzerland | Emergency calls and connected ambulance records | 27,886 (before) and 38,748(after) | Criteria Based Dispatch | Severity of cases assessed by paramedics on site using the NACA-score was used as reference |
Category | Author, year | Sensitivity % (95% CI) | Specificity % (95% CI) | PPV % (95% CI) | NPV % (95% CI) | Over-triage % (95% CI) | Under-triage % (95% CI) |
---|---|---|---|---|---|---|---|
Stroke | Clawson et al., 2016 | 86.4 | 26.6 | 20.0 | 90.2 | ||
Dami et al., 2017 | 67.8 (54.3–79.4) | 98.6 (98.4–98.7) | 9.4 (6.6–12. | 99.9 (99.9–99.9) | |||
Malekzadeh et al., 2015 | 11.6 vs 20.8 | 10.7 vs 13.6 | |||||
Krebes et al., 2012 | Stroke: 53.3 (47.0–59.0) | 97 (97–98) | Stroke: 47.8 (42.0–54.0) | 98 (97–98) | |||
Viereck et al., 2016 | 66.2 (64.4–68.0) | 30.2 (29.1–31.4) | |||||
Cardiac arrest | Deakin et al., 2017 | 75.9 (74.3–77.3) | 98.6 (98.6–98.7) | 26.8 (25.88–27.7) | 99.8 (99.82–99.85) | ||
Möller et al., 2016 | Copenhagen 80.7 (77.7–84.3), Skåne 86.0 (81.3–89.8) | ||||||
Fukushima et al., 2015 | 93 | 50 | |||||
Tanaka et al., 2014 | 72.9 (71.7–74.1) | 99.6 (99.6–99.6) | |||||
Vaillancourt et al., 2015 | 65.9 (63.5–68.2) | 32.3 (29.0–35.9) | 67.4 | 30.9 | |||
Acute coronary syndrome | Gellerstedt et al., 2016 | 82.6 | |||||
Major trauma | Giannokopoulos et al., 2012 | 87.7 | 45.3 | 48.4 | 86.3 | 44 | 20.6 |
Wilmer et al., 2015 | MOI + INT: 80.2 | MOI: 41.2 | REQ/all: 19.7 | ||||
INT: 30.2 | |||||||
REQ: 27.7 | |||||||
Medical priority | Ball et al., 2016 | 93.32 (92.71–93.89) | 48.6 (48.45–48.89) | ||||
Dami et al., 2015 | 86 (85.6–86.4) | 48 (47.4–48.6) | 21.7 (21.2–22-2) | 95.4 (95.2–95.6) | 78 | 4.6 | |
Ek et al., 2013 | 93.32 | 15.4 | |||||
Leopardi et al., 2013 | 78.0 (76.9–79.1) | 83.8 (83.4–84.1) | 36.6 (35.8–37.5) | 96.9 (96.8–97.1) | |||
Moser et al., 2017 | A + B 86.8 (86.5–87.1) | A + B 67.4 (66.9–67.9) | 29.2 (28.7–29.7) | 97.0 (70.3–71.3) | After 70.8 (70.3–71.3) | After 3.0 (2.8–3.2) |