Table 3 Descriptions of Pre-hospital Imaging Technologies and Outcomes
Study Details | Portability and Resolution | Expertise and training requirements | Person interpreting output | Location (on scene; stationary ambulance; in transit) | Purpose, Diagnostic accuracy, comparator and clinical scale | Physical invasiveness and time to acquire results | Acceptability: clinicians and/or patients | Impact on EMS clinician decisions or treatment provision | Impact on process (time metrics) or patient outcomes | Costs |
|---|---|---|---|---|---|---|---|---|---|---|
“Handheld Infra-red screening device” Murphy et al. 2015 [24] Electromagnetic Spectroscopy – Light FDA approved CE Marked ISO certificatio | Portability: Highly portable (hand-held) Resolution: Low resolution | Expertise: Qualified Paramedic Training: required | EMS clinician | In transit | Purpose: Diagnostic -Stroke -Mimic -Haemorrhage Diagnostic accuracy: Haemorrhage vs Mimic False Positive Rate: 15 False Negative Rate: 2 True Positive Rate: 5 True Negative Rate: 10 Extrapolated Values: Sensitivity: 71% Specificity: 40% Haemorrhage vs Ischaemia False Positive Rate: 8 False Negative Rate: 2 True Positive Rate: 5 True Negative Rate: 6 Extrapolated Values: Sensitivity: 71% Specificity: 42% Comparator: CT (hospital) scan Clinical scale: stroke assessment form | Non-invasive Time to acquire results: 2–3 min | Clinicians: 2–3 min too long (+increased FPR if time reduced). Measurements performed during fast ambulance transport appeared to cause false positive readings Unreliable measurement for combative and epileptic patients. | Destination: None Treatment: Not reported | Not reported | Not reported |
Electra-Stroke Coutinho 2019 [25] EEG Waveguard™ dry electrode cap and the eego™ amplifier are both CE marked | Portability: Portable with use of a vehicle Resolution: Low Resolution | Expertise: Qualified paramedic Training: Not reported | Unclear | In transit Other locations unclear | Purpose: Diagnostic -LVO-a Diagnostic accuracy: Results not yet available Comparator: Final (hospital) diagnosis Clinical scale: mRS, NIHSS | Non-invasive Time to acquire results: ‘Under 5 min’ | Results not yet available | Destination: Results not yet available Treatment: Results not yet available | Results not yet available | Not reported |