Evidence map›Paper›PMID 37391836›Full record

Trial reportCritical care (London, England)2023

Telemedical support for prehospital emergency medical service in severe emergencies: an open-label randomised non-inferiority clinical trial.

Ana Kowark, Marc Felzen, Sebastian Ziemann, Stephanie Wied, Michael Czaplik, Stefan K Beckers, Jörg C Brokmann, Ralf-Dieter Hilgers, Rolf Rossaint, TEMS-study group

Registry-linked trialAbstract readRandomized Controlled TrialEquivalence Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Critical care (London, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02617875 (Telemedical Support for Prehospital Emergency Medical Service - a Prospective Randomized Controlled Trial), which is not on this map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
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.

NCT02617875 nacompletednot on this map

Telemedical Support for Prehospital Emergency Medical Service - a Prospective Randomized Controlled Trial

TypeinterventionalSponsorRWTH Aachen UniversityRan2018 to 2019Enrolled3,534ConditionsEmergencyArmsconventional EMS physician, tele-EMS physician
3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
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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

10 authors.

Ana Kowark *Department of Anaesthesiology, Medical Faculty, University Hospital RWTH Aachen, Aachen, Germany.
Marc Felzen *Department of Anaesthesiology, Medical Faculty, University Hospital RWTH Aachen, Aachen, Germany.
Sebastian ZiemannDepartment of Anaesthesiology, Medical Faculty, University Hospital RWTH Aachen, Aachen, Germany.
Stephanie WiedDepartment of Medical Statistics, Medical Faculty, University Hospital RWTH Aachen, Aachen, Germany.
Michael CzaplikDepartment of Anaesthesiology, Medical Faculty, University Hospital RWTH Aachen, Aachen, Germany.
Stefan K BeckersDepartment of Anaesthesiology, Medical Faculty, University Hospital RWTH Aachen, Aachen, Germany.
Jörg C BrokmannEmergency Department, Medical Faculty, University Hospital RWTH Aachen, Aachen, Germany.
Ralf-Dieter Hilgers *Department of Medical Statistics, Medical Faculty, University Hospital RWTH Aachen, Aachen, Germany.
Rolf Rossaint *Department of Anaesthesiology, Medical Faculty, University Hospital RWTH Aachen, Aachen, Germany. rrossaint@ukaachen.de.
TEMS-study group

Funding

Deutsche Forschungsgemeinschaft DFG RO2000/21-1
6 · The paper itself

Abstract

backgroundA tele-emergency medical service with a remote emergency physician for severe prehospital emergencies may overcome the increasing number of emergency calls and shortage of emergency medical service providers. We analysed whether routine use of a tele-emergency medical service is non-inferior to a conventional physician-based one in the occurrence of intervention-related adverse events.

methodsThis open-label, randomised, controlled, parallel-group, non-inferiority trial included all routine severe emergency patients aged ≥ 18 years within the ground-based ambulance service of Aachen, Germany. Patients were randomised in a 1:1 allocation ratio to receive either tele-emergency medical service (n = 1764) or conventional physician-based emergency medical service (n = 1767). The primary outcome was the occurrence of intervention-related adverse events with suspected causality to the group assignment. The trial was registered with ClinicalTrials.gov (NCT02617875) on 30 November 2015 and is reported in accordance with the CONSORT statement for non-inferiority trials.

resultsAmong 3531 randomised patients, 3220 were included in the primary analysis (mean age, 61.3 years; 53.8% female); 1676 were randomised to the conventional physician-based emergency medical service (control) group and 1544 to the tele-emergency medical service group. A physician was not deemed necessary in 108 of 1676 cases (6.4%) and 893 of 1544 cases (57.8%) in the control and tele-emergency medical service groups, respectively. The primary endpoint occurred only once in the tele-emergency medical service group. The Newcombe hybrid score method confirmed the non-inferiority of the tele-emergency medical service, as the non-inferiority margin of - 0.015 was not covered by the 97.5% confidence interval of - 0.0046 to 0.0025.

conclusionsAmong severe emergency cases, tele-emergency medical service was non-inferior to conventional physician-based emergency medical service in terms of the occurrence of adverse events.

Indexed as

Emergency Medical ServicesPhysiciansTelemedicineEmergenciesFemaleGermanyHumansMaleMiddle AgedAdverse events in pre-hospital emergenciesEmergency medical serviceRemote emergency physicianTele-emergency medical serviceTelemedicine

Identifiers

PMID37391836
PMCPMC10311733

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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.