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Dispatching Software Misses More Than Half of Strokes

Telephone-based software used in emergency dispatch missed 66 of 126 strokes in U.K. study

TUESDAY, May 26 (HealthDay News) -- The telephone-based software used to prioritize emergency ambulance response failed to identify more than half the incidents of stroke over a six-month period, according to a study in the June Emergency Medicine Journal.

Charles D. Deakin, M.D., of the South Central Ambulance Service in Otterbourne, U.K., and colleagues reviewed all emergency ambulance dispatches to the North Hampshire Hospital emergency department over six months and compared the clinical coding by advanced medical priority dispatch software (AMPDS, version 11.1) to the patients' final clinical diagnosis to determine how well acute stroke was identified by the software.

Of the 4,810 patients brought to the North Hampshire Hospital during the study period, 126 patients were diagnosed with a stroke, 60 of whom were correctly identified as having a stroke by the software, while 66 strokes were missed, the investigators discovered. Another 62 patients were falsely identified by the software as having a stroke. The sensitivity of the software for detecting stroke was calculated at 47.62 percent, and specificity was 98.68 percent. The positive predictive value was 0.49 compared to a negative predictive value of 0.986, the authors note.

"Fewer than half of all patients with acute stroke were identified using telephone triage on the initial emergency call to the ambulance service. Less than one quarter received the highest priority of ambulance response. This first link in the chain of survival needs strengthening in order to provide prompt and timely emergency care for these patients," the authors conclude.

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