Trial reportScandinavian journal of trauma, resuscitation and emergency medicine2017
A comparison of two emergency medical dispatch protocols with respect to accuracy.
Trial report in Scandinavian journal of trauma, resuscitation and emergency medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- Pooled it
- Overtriage of a physician-staffed prehospital emergency resource in Austria : An exploratory retrospective analysis.Wiener klinische Wochenschrift · 2026Article
- Article
- Multi-method approach to the development of contextual telephone triage systems.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2026Article
- Geographic distribution of EMS missions and patient conditions in suburban and rural Sweden: a retrospective observational study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Observational
- Dispatch Decisions and Emergency Medical Services Response in the Prehospital Care of Status Epilepticus.The western journal of emergency medicine · 2025Article
- A Literature Study of Medical Simulations for Non-Technical Skills Training in Emergency Medicine: Twenty Years of Progress, an Integrated Research Framework, and Future Research Avenues.International journal of environmental research and public health · 2023Article
- The potential of new prediction models for emergency medical dispatch prioritisation of patients with chest pain: a cohort study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2022Observational
- A longitudinal, retrospective registry-based validation study of RETTS©, the Swedish adult ED context version.Scandinavian journal of trauma, resuscitation and emergency medicine · 2022Article
- Priority accuracy by dispatch centers and Emergency Medical Services professionals in trauma patients: a cohort study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Observational
- Towards enhanced telephone triage for chest pain: a Delphi study to define life-threatening conditions that must be identified.BMC emergency medicine · 2021Article
- Mobilisation of emergency services for chemical incidents in Sweden - a multi-agency focus group study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2021Article
- Outpatient care in acute and prehospital emergency medicine by emergency medical and patient transport service over a 10-year period: a retrospective study based on dispatch data from a German emergency medical dispatch centre (OFF-RESCUE).BMC emergency medicine · 2021Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEmergency medical dispatching should be as accurate as possible in order to ensure patient safety and optimize the use of ambulance resources. This study aimed to compare the accuracy, measured as priority level, between two Swedish dispatch protocols - the three-graded priority protocol Medical Index and a newly developed prototype, the four-graded priority protocol, RETTS-A.
methodsA simulation study was carried out at the Emergency Medical Communication Centre (EMCC) in Stockholm, Sweden, between October and March 2016. Fifty-three voluntary telecommunicators working at SOS Alarm were recruited nationally. Each telecommunicator handled 26 emergency medical calls, simulated by experienced standard patients. Manuscripts for the scenarios were based on recorded real-life calls, representing the six most common complaints. A cross-over design with 13 + 13 calls was used. Priority level and medical condition for each scenario was set through expert consensus and used as gold standard in the study.
resultsA total of 1293 calls were included in the analysis. For priority level, n = 349 (54.0%) of the calls were assessed correctly with Medical Index and n = 309 (48.0%) with RETTS-A (p = 0.012). Sensitivity for the highest priority level was 82.6% (95% confidence interval: 76.6-87.3%) in the Medical Index and 54.0% (44.3-63.4%) in RETTS-A. Overtriage was 37.9% (34.2-41.7%) in the Medical Index and 28.6% (25.2-32.2%) in RETTS-A. The corresponding proportion of undertriage was 6.3% (4.7-8.5%) and 23.4% (20.3-26.9%) respectively.
conclusionIn this simulation study we demonstrate that Medical Index had a higher accuracy for priority level and less undertriage than the new prototype RETTS-A. The overall accuracy of both protocols is to be considered as low. Overtriage challenges resource utilization while undertriage threatens patient safety. The results suggest that in order to improve patient safety both protocols need revisions in order to guarantee safe emergency medical dispatching.
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