Study Shows Race and Sex Disparities in Prehospital Stroke Recognition

In this study, Govindarajan, from the University of California, San Francisco, led a diverse team of researchers comparing hospital discharge diagnosis to field impressions documented in EMS electronic charts from two California counties. The team used probabilistic linking to retrospectively associate EMS and hospital database records. They analyzed records from 14 hospitals in these two counties from 2005– 2007, and identified 10,719 stroke patients. Retrospective "data-mining" practices with large databases pose serious threats to the validity of a study. In this case however, researchers did a great job of finding all patients who were discharged with a diagnosis of stroke, and then narrowing those down to patients who were transported by ambulance. They linked 3,787 patient records. Results: EMS documented stroke as their field impression in only 1,223 patients (sensitivity = 32%). Unfortunately this means that either EMS didn’t document well, the patients hadn’t yet developed identifiable symptoms or, more alarmingly, EMS didn’t recognize the stroke. The good news is that crews were extremely accurate (specificity = 99%) in those they did identify.
Source: JEMS Patient Care - Category: Emergency Medicine Authors: Tags: Special Topics Cardiac & Resuscitation Research Columns Patient Care Source Type: news