{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T06:17:20Z","timestamp":1788329840396,"version":"build-2803163510"},"reference-count":55,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"17","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">International reports highlight the COVID\u201019 pandemic's wide\u2010ranging impacts on time\u2010sensitive conditions, including stroke\/transient ischemic attack (TIA). Comparing ambulance time intervals globally offers insights into COVID\u201019's effects on different health care systems. This study aimed to compare ambulance time intervals for adults with suspected stroke\/TIA across 7 services before and during the COVID\u201019 pandemic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">We conducted a quasi\u2010experimental before\u2010and\u2010after study examining the impact of COVID\u201019 on 5 ambulance time intervals and call volume for suspected stroke\/TIA cases. International ambulance services using the Advanced Medical Priority Dispatch System provided data on all suspected stroke\/TIA calls. Outcomes were compared between the pre\u2010COVID\u201019 period (January 1, 2018, to the week before first identified case) and the COVID\u201019 period (first identified case to December 31, 2021) using descriptive, time\u2010series, and regression analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">Four national (Republic of Ireland, New Zealand, Northern Ireland, and Scotland) and 3 regional (Queensland, Tilburg, and Vienna) services provided data on 273\u2009362 suspected stroke\/TIA cases. No consistent effect was observed on allocation performance, mobilization performance, or conveyance time. Mean response time increased significantly in all services (0.5\u20139.13\u2009minutes) except New Zealand, where it decreased by 1.57\u2009minutes. Mean on\u2010scene time increased significantly across all services (1.05\u20133.78\u2009minutes). Mean monthly call volume per 1000 emergency calls increased significantly in 6 services (16\u201340.5 cases), whereas the Netherlands showed no change.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Aligning time interval definitions across 7 ambulance services highlighted response and on\u2010scene times as key contributors to prehospital delays during the pandemic. Future interventions should focus on these prehospital phases, particularly during times of increased pressure on the health care system.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.124.040350","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T11:14:39Z","timestamp":1787829279000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["International Comparison of Ambulance Time Intervals for Suspected Stroke\/Transient Ischemic Attack Across 7 Emergency Medical Services Before and During the COVID\u201019 Pandemic"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5847-0174","authenticated-orcid":false,"given":"Edel","family":"Burton","sequence":"first","affiliation":[{"name":"University College Cork","place":["Cork City, Cork, 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