Observational studyScandinavian journal of trauma, resuscitation and emergency medicine2019
Diagnostic accuracy of physician-staffed emergency medical teams: a retrospective observational cohort study of prehospital versus hospital diagnosis in a 10-year interval.
Observational study in Scandinavian journal of trauma, resuscitation and emergency medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Diagnostic agreement between prehospital and in-hospital diagnoses for dyspnea: a retrospective study in a French prehospital emergency medical service.BMC emergency medicine · 2026Article
- Early Identification of Sepsis by Emergency Medical Services: Diagnostic Accuracy of Scoring Systems in a Retrospective Cohort.Journal of clinical medicine · 2026Article
- A European paramedic curriculum for geriatric emergency medicine developed via a modified Delphi technique.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Article
- Comparison of the diagnostic concordance of tele-EMS and EMS physicians in the emergency medical service-a subanalysis of the TEMS-trial.Frontiers in digital health · 2025Article
- Article
- Prehospital Misdiagnosed Acute Coronary Syndrome-Incidence, Discriminating Features, and Differential Diagnoses.Reviews in cardiovascular medicine · 2023Article
- Characteristics of low acuity prehospital emergency patients with 48-h mortality, an observational cohort study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2022Observational
- The COVID-19 pandemic effect on the prehospital Madrid stroke code metrics and diagnostic accuracy.PloS one · 2022Observational
- Observational
- Management of respiratory distress following prehospital implementation of noninvasive ventilation in a physician-staffed emergency medical service: a single-center retrospective study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2021Article
- Evaluation of a Prehospital Rotation by Senior Residents: A Web-Based Survey.Healthcare (Basel, Switzerland) · 2020Article
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn Germany, emergency medical teams are staffed with physicians but evidence regarding their prehospital diagnostic accuracy remains poor.
objectiveTo evaluate the out-of-hospital diagnostic accuracy of physician-staffed emergency medical teams (PEMTs).
methodsA retrospective observational cohort study involving the Emergency Medical Service Bonn, Germany, from January to December 2004 and 2014 respectively. A total of 8346 patients underwent medical treatment by PEMTs, of which 1960 adult patients (inclusion criteria: ≥18 years of age, hospital diagnosis available) were included for further analysis. Reasons for non-inclusion: death on scene, outpatient, interhospital transfer, mental illness, false alarm, no hospital medical history available. The overall diagnostic accuracy (correct or false) of PEMTs was measured after matching the prehospital diagnosis with the corresponding diagnosis of the hospital. Secondary outcome measures were incidence of common PEMT diagnoses (acute coronary syndrome (ACS), dyspnea, stroke/intracerebral bleeding), recognition rate of a given disease by PEMTs, and prehospital diagnostic accuracy in elderly patients.
resultsPEMT calls increased 2-fold over a decade (2004: n = 3151 vs. 2014: n = 5195). Overall diagnostic accuracy of PEMTs increased from 87.5% in 2004 to 92.6% in the year 2014. The incidence of common PEMT diagnoses such as ACS, dyspnea or stroke/intracerebral bleeding increased 2-fold from 2004 to 2014. The recognition rate of a given disease by the PEMT varied between 2004 and 2014: an increase was observed when a stroke/intracerebral bleeding was diagnosed (2004: 67% vs. 2014: 83%; p = 0.054), a decreased rate of recognition occurred when a syncope/collapse was diagnosed (2004: 81% vs. 2014: 56%; p = 0.007) and a sepsis appears to be a rare event for EMS personnel (2004: 0% vs. 2014: 23%). Linear regression analysis revealed that the prehospital diagnostic accuracy decreases in the elderly patient.
conclusionsThe overall prehospital diagnostic accuracy of PEMTs improved between the year 2004 and 2014 respectively. Our findings suggest that the incidence of common diseases (ACS, dyspnea stroke/intracerebral bleeding, sepsis) increased over a 10-year period. Diagnostic accuracy of different diseases varied but generally decreased in the elderly patient. Regular training of EMS personnel and public campaigns should be implemented to improve the diagnostic accuracy in the future.
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