Study designs of evaluations included in the review
Studies with a control group were eligible for inclusion.
Specific interventions included in the review
Studies comparing PHECG and advance hospital notification with standard emergency medical service care were eligible for inclusion. In the included studies PHECG was conducted by a paramedic, or in one study a paramedic or a nurse, and interpreted by an emergency physician, a paramedic or by computer.
Participants included in the review
Patients with suspected AMI were eligible for inclusion. The included studies were conducted in urban, rural or mixed settings.
Outcomes assessed in the review
The primary outcomes assessed were all-cause in-hospital mortality and time intervals such as time of symptom onset to treatment, on-scene time interval and time to treatment from arrival in the ED.
How were decisions on the relevance of primary studies made?
Two authors independently screened studies, blinded to the author, year of publication, journal, results and conclusions. Any disagreements were resolved by consensus. Agreement between reviewers was assessed using a weighted kappa statistic and was found to be 0.61 (standard error, SE=0.045) for titles, 0.63 (SE=0.051) for abstracts and 0.79 (SE=0.146) for full articles.