Evidence map›Paper›PMID 40802682›Full record

ArticlePloS one2025

Methods for improving the identification of acute stroke during ambulance calls: A scoping review.

Areej Almutairi, Fadila Wirawan, Adam Lloyd, Tom Moullaali, Gareth Clegg

Abstract readScoping Review
In one paragraph

Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
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

5 authors.

Areej AlmutairiUsher Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom.ORCID https://orcid.org/0009-0000-8032-6024
Fadila WirawanUsher Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom.
Adam LloydScottish Ambulance Service, Edinburgh, Scotland, United Kingdom.
Tom MoullaaliCentre for Clinical Brain Sciences, University of Edinburgh, Scotland, United Kingdom.
Gareth CleggUsher Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAccurately identifying strokes during ambulance calls remains challenging, leading to low diagnostic accuracy and delays in dispatching appropriate services. Limited evidence exists regarding methods for improving call handlers' stroke recognition. This scoping review explores methods for enhancing stroke identification during emergency calls in ambulance control centres (ACCs).

methodsWe conducted a scoping review following the methodology of the Joanna Briggs Institute and adhered to PRISMA-ScR guidelines. A systematic search was performed across five databases: Embase, Medline, Scopus, Web of Science, and CINAHL, also grey literature sources, covering publications from January 1964 to July 2024. We included studies that examined methods to improve stroke identification during emergency calls in ACCs. To assess the effectiveness of these methods, eligible studies must evaluate at least one of the following outcomes: accuracy of stroke diagnosis, time to diagnosis, effectiveness of staff training, and acceptability of identification techniques. Two reviewers independently screened the studies, extracted the data, and conducted an inductive thematic analysis to identify common themes.

resultsOf the 3,619 studies identified, seven met the inclusion criteria. Included studies focused on technology and algorithms (n = 3), training and educational programs (n = 2), and improved triage tools (n = 2) to enhance stroke identification during emergency calls to ACCs. Studies on technology and algorithms have reported increased stroke identification sensitivity and positive predictive value (PPV) when using new algorithms compared to standard protocols. Training programs have led to improved dispatcher sensitivity in stroke recognition. Improved triage tools also reduce time-to-diagnosis and facilitate quicker emergency responses.

conclusionThis review highlights several methods for improving stroke identification in ACCs. Despite improvements in PPV, sensitivity, and diagnosis time, the lack of generalised standards, single-centre studies, and various population characteristics hinder broader impact. Future research should prioritise well-designed studies with standardised benchmarks to determine effectiveness, enabling effective prehospital stroke identification strategies.

Indexed as

AmbulancesEmergency Medical ServicesStrokeHumans

Identifiers

PMID40802682
PMCPMC12349133

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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.