{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T05:55:42Z","timestamp":1771480542033,"version":"3.50.1"},"reference-count":20,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2016,7,10]],"date-time":"2016-07-10T00:00:00Z","timestamp":1468108800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Emerg Medicine Australasia"],"published-print":{"date-parts":[[2016,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The present study aims to determine the agreement between paramedic and ED or hospital working diagnosis in dyspnoeic patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Non\u2010consecutive written patient report forms were retrospectively audited for patients suffering from dyspnoea, who were transported to a tertiary hospital ED by ambulance paramedics. Accuracy of the paramedic working diagnosis was assessed by comparing agreement with either the primary or secondary ED diagnoses or hospital discharge diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study cohort was 293 patients. Exact agreement between paramedic <jats:italic>versus<\/jats:italic> ED or hospital diagnosis was 64%, 95% CI 58\u201369, <jats:italic>k<\/jats:italic>\u00a0=\u00a00.58, 95% CI 0.52\u20130.64. Only 226 (77%) had a \u2018clearly documented\u2019 paramedic diagnosis. Among these, agreement with either ED or hospital diagnosis was 79%, and there was a trend towards more agreement as paramedic level of practice increased (74%, 78% and 87% for Basic, Intermediate and ALS paramedics, respectively, <jats:italic>P<\/jats:italic>\u2009=\u20090.07). Conversely, ALS paramedics were less likely to document a working diagnosis (30\/98, 31%) compared with Intermediate (22\/102, 23%) and BLS paramedics (15\/93, 16%), <jats:italic>P<\/jats:italic>\u2009=\u20090.008. Diagnostic agreement varied according to medical condition, from anaphylaxis (100%) and asthma (86%) to acute pulmonary oedema (46%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There was moderate agreement between paramedic and ED or hospital diagnosis. The number of cases with no clearly documented working diagnosis suggested that a singular working diagnosis may not always serve the complexity of presentation of some dyspnoea patients: more open descriptors such as \u2018mixed disease\u2019 or \u2018atypical features\u2019 should be encouraged.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1742-6723.12618","type":"journal-article","created":{"date-parts":[[2016,7,11]],"date-time":"2016-07-11T01:12:59Z","timestamp":1468199579000},"page":"525-530","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Accuracy of working diagnosis by paramedics for patients presenting with dyspnoea"],"prefix":"10.1111","volume":"28","author":[{"given":"Andrew","family":"Christie","sequence":"first","affiliation":[{"name":"St John Ambulance  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brenda","family":"Costa\u2010Scorse","sequence":"additional","affiliation":[{"name":"Discipline of Paramedicine, School of Clinical Sciences, Faculty of Health and Environmental Science Auckland University of Technology  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mike","family":"Nicholls","sequence":"additional","affiliation":[{"name":"Emergency Department Auckland City Hospital  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Jones","sequence":"additional","affiliation":[{"name":"Emergency Department Auckland City Hospital  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6907-8074","authenticated-orcid":false,"given":"Graham","family":"Howie","sequence":"additional","affiliation":[{"name":"Discipline of Paramedicine, School of Clinical Sciences, Faculty of Health and Environmental Science Auckland University of Technology  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,7,10]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/10903120500366888"},{"key":"e_1_2_8_3_1","first-page":"38","article-title":"Pulmonary edema or pneumonia? 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