Accuracy of Medically Experienced Emergency Dispatchers – A Unique Nationwide Model

Background: This research examined the accuracy of the Israeli model of emergency medical dispatch by comparing dispatchers' preliminary diagnosis with the working diagnosis of paramedics in the field. Methods: Data from emergency medical calls received by Magen David Adom between January 1st 2019 and December 31st 2019 were included. Primary analysis was done by directly comparing preliminary diagnoses made by dispatchers to the diagnoses made by paramedics. Secondary analysis was done by comparing the system identified by the dispatchers' preliminary diagnoses to the system identified by the paramedics' diagnoses. Tertiary analysis was done by subgrouping symptoms and syndromes by an expert panel to create a new preliminary diagnosis which was then compared with paramedic diagnosis. Results: Primary analysis showed a sensitivity of 48.8%, specificity of 97.3%, PPV of 53.0%, and NPV of 98.0%. Secondary analysis showed a sensitivity of 78.6%, specificity of 88.4%, PPV of 26.5%, and NPV of 99.2%. Tertiary analysis showed a sensitivity of 49.8%, specificity of 97.3%, PPV of 54.4%, and NPV of 97.9%. Conclusion: Medically experienced emergency dispatchers were able to obtain a high level of sensitivity determining preliminary diagnoses compared to ambulance crews in the field. Further research should focus on widening the variety of diagnoses investigated.