{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T03:58:14Z","timestamp":1787111894079,"version":"build-2736575974"},"reference-count":16,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2019,2,13]],"date-time":"2019-02-13T00:00:00Z","timestamp":1550016000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Gyllenberg Foundation"},{"name":"Erkko Foundation"},{"name":"the Finnish Medical Foundation"},{"name":"Sigrid Jus\u00e9lius foundation"},{"name":"Aarne & Aili Turunen Foundation"},{"name":"The Finnish Heart Foundation"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Stroke"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Accurate identification of acute stroke by Emergency Medical Dispatchers (EMD) is essential for timely and purposeful deployment of Emergency Medical Services (EMS), and a prerequisite for operating mobile stroke units. However, precision of EMD stroke recognition is currently modest.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>We sought to identify targets for improving dispatcher stroke identification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Dispatch codes and EMS patient records were cross-linked to investigate factors associated with an incorrect dispatch code in a prospective observational cohort of 625 patients with a final diagnosis of acute stroke or transient ischemic attack (TIA), transported to our stroke center as candidates for recanalization therapies. Call recordings were analyzed in a subgroup that received an incorrect low-priority dispatch code indicating a fall or unknown acute illness ( n\u2009=\u200946).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Out of 625 acute stroke\/TIA patients, 450 received a high-priority stroke dispatch code (sensitivity 72.0%; 95% CI, 68.5\u201375.5). Independent predictors of dispatcher missed acute stroke included a bystander caller (aOR, 3.72; 1.48\u20139.34), confusion (aOR, 2.62; 1.59\u20134.31), fall at onset (aOR, 1.86; 1.24\u20132.78), and older age (aOR [per year], 1.02; 1.01\u20131.04). Of the analyzed call recordings, 71.7% revealed targets for improvement, including failure to recognize a Face Arm Speech Time (FAST) test symptom (21\/46 cases, 18 with speech disturbance), or failure to thoroughly evaluate symptoms (12\/46 cases).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Based on our findings, efforts to improve dispatcher stroke identification should primarily focus on improving recognition of acute speech disturbance, and implementing screening of FAST-symptoms in emergency phone calls revealing a fall or confusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration<\/jats:title>\n                    <jats:p>URL: http:\/\/www.clinicaltrials.gov . Unique identifier: NCT02145663.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1747493019830315","type":"journal-article","created":{"date-parts":[[2019,2,13]],"date-time":"2019-02-13T20:37:03Z","timestamp":1550090223000},"page":"409-416","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":20,"title":["Targets for improving dispatcher identification of acute stroke"],"prefix":"10.1177","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4706-8558","authenticated-orcid":false,"given":"Olli S","family":"Mattila","sequence":"first","affiliation":[{"name":"Neurology, Clinical Neurosciences, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"},{"name":"Molecular Neurology, Research Programs Unit, University of Helsinki, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuukka","family":"Puolakka","sequence":"additional","affiliation":[{"name":"Emergency Medicine and Services, Department of Emergency Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juhani","family":"Ritvonen","sequence":"additional","affiliation":[{"name":"Molecular Neurology, Research Programs Unit, University of Helsinki, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saana","family":"Pihlasviita","sequence":"additional","affiliation":[{"name":"Molecular Neurology, Research Programs Unit, University of Helsinki, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heini","family":"Harve","sequence":"additional","affiliation":[{"name":"Emergency Medicine and Services, Department of Emergency Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ari","family":"Alanen","sequence":"additional","affiliation":[{"name":"Emergency Response Center Administration, Kerava, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerli","family":"Sibolt","sequence":"additional","affiliation":[{"name":"Neurology, Clinical Neurosciences, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sami","family":"Curtze","sequence":"additional","affiliation":[{"name":"Neurology, Clinical Neurosciences, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Strbian","sequence":"additional","affiliation":[{"name":"Neurology, Clinical Neurosciences, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikko","family":"Pystynen","sequence":"additional","affiliation":[{"name":"Emergency Medicine and Services, Department of Emergency Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Turgut","family":"Tatlisumak","sequence":"additional","affiliation":[{"name":"Neurology, Clinical Neurosciences, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"},{"name":"Department of Clinical Neuroscience\/Neurology, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg"},{"name":"Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markku","family":"Kuisma","sequence":"additional","affiliation":[{"name":"Emergency Medicine and Services, Department of Emergency Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Perttu J","family":"Lindsberg","sequence":"additional","affiliation":[{"name":"Neurology, Clinical Neurosciences, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"},{"name":"Molecular Neurology, Research Programs Unit, University of Helsinki, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,2,13]]},"reference":[{"key":"bibr1-1747493019830315","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.113.002910"},{"key":"bibr2-1747493019830315","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2013.07.039"},{"key":"bibr3-1747493019830315","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.111.634980"},{"key":"bibr4-1747493019830315","doi-asserted-by":"crossref","unstructured":"Oostema JA, Carle T, Talia N and Reeves M. Dispatcher stroke recognition using a stroke screening tool: a systematic review.\n                      Cerebrovasc Dis\n                      2016; 42: 370\u2013377.","DOI":"10.1159\/000447459"},{"key":"bibr5-1747493019830315","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0b013e318284056a"},{"key":"bibr6-1747493019830315","doi-asserted-by":"crossref","unstructured":"Puolakka T, Strbian D, Harve H, Kuisma M and Lindsberg PJ. Prehospital phase of the stroke chain of survival: a prospective observational study.\n                      J Am Heart Assoc\n                      2016; 5: e002808.","DOI":"10.1161\/JAHA.115.002808"},{"key":"bibr7-1747493019830315","doi-asserted-by":"crossref","unstructured":"Puolakka T, V\u00e4yrynen T, H\u00e4pp\u00f6l\u00e4, Soinne L, Kuisma M and Lindsberg PJ. Sequential analysis of pretreatment delays in stroke thrombolysis.\n                      Acad Emerg Med\n                      2010; 17: 965\u2013969.","DOI":"10.1111\/j.1553-2712.2010.00828.x"},{"key":"bibr8-1747493019830315","doi-asserted-by":"publisher","DOI":"10.1111\/ane.12687"},{"key":"bibr9-1747493019830315","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000071111.98505.C7"},{"key":"bibr10-1747493019830315","doi-asserted-by":"crossref","unstructured":"Meretoja A, Strbian D, Mustanoja S, Tatlisumak T, Lindsberg PJ and Kaste, M. Reducing inhospital delay to 20 minutes in stroke thrombolysis.\n                      Neurology\n                      2012; 79: 306\u2013313.","DOI":"10.1212\/WNL.0b013e31825d6011"},{"key":"bibr11-1747493019830315","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000005954"},{"key":"bibr12-1747493019830315","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.116.014531"},{"key":"bibr13-1747493019830315","doi-asserted-by":"publisher","DOI":"10.1111\/j.1747-4949.2011.00749.x"},{"key":"bibr14-1747493019830315","doi-asserted-by":"crossref","unstructured":"Mosley I, Nicol M, Donnan G, Patrick I and Dewey H. Stroke symptoms and the decision to call for an ambulance.\n                      Stroke\n                      2007; 38: 361\u2013366.","DOI":"10.1161\/01.STR.0000254528.17405.cc"},{"key":"bibr15-1747493019830315","doi-asserted-by":"crossref","unstructured":"Berglund A, Euler von M, Schenck-Gustafsson K, Castr\u00e9n M and Bohm K. Identification of stroke during the emergency call: a descriptive study of callers presentation of stroke.\n                      BMJ Open\n                      2015; 5: e007661.","DOI":"10.1136\/bmjopen-2015-007661"},{"key":"bibr16-1747493019830315","doi-asserted-by":"publisher","DOI":"10.1097\/MEJ.0b013e32835015ac"}],"container-title":["International Journal of Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1747493019830315","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1747493019830315","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1747493019830315","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T07:17:02Z","timestamp":1777706222000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1747493019830315"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2,13]]},"references-count":16,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2019,6]]}},"alternative-id":["10.1177\/1747493019830315"],"URL":"https:\/\/doi.org\/10.1177\/1747493019830315","relation":{},"ISSN":["1747-4930","1747-4949"],"issn-type":[{"value":"1747-4930","type":"print"},{"value":"1747-4949","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,2,13]]}}}