Evidence map›Paper›PMID 30755249›Full record

ArticleTrials2019

Paramedic Acute Stroke Treatment Assessment (PASTA): study protocol for a randomised controlled trial.

Christopher I Price, Lisa Shaw, Peter Dodd, Catherine Exley, Darren Flynn, Richard Francis, Saiful Islam, Mehdi Javanbakht, Rachel Lakey, Joanne Lally and 9 more

Registry-linked trialOpen access · goldAbstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in Trials, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07027813 (Feasibility and Efficacy of Ambulance-Based m-Health for Pediatric Emergencies in Low Resource Settings), which is not on this map. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 pooled it
1.4field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

NCT07027813 narecruitingnot on this mapstarted 2025, after this paper: background citation

Feasibility and Efficacy of Ambulance-Based m-Health for Pediatric Emergencies in Low Resource Settings (FEAMER) Trial

TypeinterventionalSponsorWeill Medical College of Cornell UniversityRan2025 to 2026Enrolled900ConditionsEmergencies, mHealth, Child Health, Critical IllnessArmsTelemedicine, Control
3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.

  1. A systematic review of ambulance service-based randomised controlled trials in stroke.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2023
    Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors at 7 institutions in 1 country.

Christopher I PriceStroke Research Group, Institute of Neuroscience, Newcastle University, 3-4 Claremont Terrace, Newcastle upon Tyne, NE2 4AE, UK. C.I.M.Price@newcastle.ac.uk.ORCID http://orcid.org/0000-0003-3566-3157
Lisa ShawStroke Research Group, Institute of Neuroscience, Newcastle University, 3-4 Claremont Terrace, Newcastle upon Tyne, NE2 4AE, UK. lisa.shaw@newcastle.ac.uk.ORCID http://orcid.org/0000-0002-3435-9519
Peter DoddLay investigator. Contact via: Stroke Research Group, Institute of Neuroscience, Newcastle University, 3-4 Claremont Terrace, Newcastle upon Tyne, NE2 4AE, UK.
Catherine ExleyInstitute of Health and Society, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK.
Darren FlynnInstitute of Health and Society, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK.
Richard FrancisStroke Research Group, Institute of Neuroscience, Newcastle University, 3-4 Claremont Terrace, Newcastle upon Tyne, NE2 4AE, UK.
Saiful IslamCollege of Medicine, Swansea University, Singleton Park, Swansea, SA2 8PP, Wales.
Mehdi JavanbakhtInstitute of Health and Society, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK.
Rachel LakeyNewcastle Clinical Trials Unit, Newcastle University, 1-4 Claremont Terrace, Newcastle upon Tyne, NE2 4AE, UK.
Joanne LallyInstitute of Health and Society, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK.
Graham McClellandNorth East Ambulance Service, Bernicia House, Goldcrest Way, Newburn Riverside, Newcastle upon Tyne, NE15 8NY, UK.
Peter McMeekinFaculty of Health & Life Sciences, Northumbria University, 2nd floor Northumberland Building, Newcastle upon Tyne, NE1 8ST, UK.
Helen RodgersStroke Research Group, Institute of Neuroscience, Newcastle University, 3-4 Claremont Terrace, Newcastle upon Tyne, NE2 4AE, UK.
Helen SnooksCollege of Medicine, Swansea University, Singleton Park, Swansea, SA2 8PP, Wales.
Louise SutcliffeStroke Research Group, Institute of Neuroscience, Newcastle University, 3-4 Claremont Terrace, Newcastle upon Tyne, NE2 4AE, UK.
Pippa TyrellStroke Medicine, Clinical Sciences Building, Salford Royal Hospitals' NHS Foundation Trust, Salford, M6 8HD, UK.
Luke ValeInstitute of Health and Society, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK.
Alan WatkinsCollege of Medicine, Swansea University, Singleton Park, Swansea, SA2 8PP, Wales.
Gary A FordMedical Sciences Division, University of Oxford, and Oxford University Hospitals NHS Foundation Trust, Level 3, John Radcliffe Hospital, Oxford, OX3 9DU, UK.
Newcastle University · GBSwansea University · GBJohn Radcliffe Hospital · GBNewcastle upon Tyne Hospitals NHS Foundation Trust · GBNorth East Ambulance Service NHS Foundation Trust · GBNorthumbria University · GBSalford Royal NHS Foundation Trust · GB

Funding

Department of Health RP-PG-1211-20012Medical Research Council MR/K02325X/1National Institute for Health Research RP-PG-1211-20012
6 · The paper itself

Abstract

backgroundDespite evidence from clinical trials that intravenous (IV) thrombolysis is a cost-effective treatment for selected acute ischaemic stroke patients, there remain large variations in the rate of IV thrombolysis delivery between stroke services. This study is evaluating whether an enhanced care pathway delivered by paramedics (the Paramedic Acute Stroke Treatment Assessment (PASTA)) could increase the number of patients who receive IV thrombolysis treatment.

methodsStudy design: Cluster randomised trial with economic analysis and parallel process evaluation.

settingNational Health Service ambulance services, emergency departments and hyper-acute stroke units within three geographical regions of England and Wales. Randomisation: Ambulance stations within each region are the units of randomisation. According to station allocation, paramedics based at a station deliver the PASTA pathway (intervention) or continue with standard stroke care (control). Study intervention: The PASTA pathway includes structured pre-hospital information collection, prompted pre-notification, structured handover of information in hospital and assistance with simple tasks during the initial hospital assessment. Study-trained intervention group paramedics deliver this pathway to adults within 4 h of suspected stroke onset. Study control: Standard stroke care according to national and local guidelines for the pre-hospital and hospital assessment of suspected stroke.

participantsParticipants enrolled in the study are adults with confirmed stroke who were assessed by a study paramedic within 4 h of symptom onset. PRIMARY OUTCOME: Proportion of participants receiving IV thrombolysis. SAMPLE SIZE: 1297 participants provide 90% power to detect a 10% difference in the proportion of patients receiving IV thrombolysis. DISCUSSION: The results from this trial will determine whether an enhanced care pathway delivered by paramedics can increase thrombolysis delivery rates.

trial registrationISRCTN registry, ISRCTN12418919 . Registered on 5 November 2015.

Indexed as

Emergency Medical ServicesRandomized Controlled Trials as TopicAdultAllied Health PersonnelCost-Benefit AnalysisHealth ResourcesHumansQuality Assurance, Health CareSample SizeStrokeThrombolytic TherapyEconomic evaluationParallel process evaluationParamedicsPre-hospital researchRCTStroke

Identifiers

PMID30755249
PMCPMC6373128
OpenAlexW2917469569

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.