{"resourceId":"copenhagen-ohca-dispatch-rct-2021","versions":[{"version":"external-02f7ab66cc633be7787384636f328dfe32ee432eea59c9b5c5ca45b610026fcc","resource":{"id":"copenhagen-ohca-dispatch-rct-2021","title":"Randomized EMS trial found no significant dispatcher recognition gain from machine-learning alerts","organization":"Copenhagen Emergency Medical Services and university collaborators","sector":"EMS dispatch","geography":"Copenhagen, Denmark; transfer to U.S. 911 requires local validation","publishedAt":"January 6, 2021","publicationDate":"2021-01-06","eventDate":null,"sourceName":"JAMA Network Open via PubMed Central","sourceLabel":"Prospective randomized clinical trial","sourceUrl":"https://pmc.ncbi.nlm.nih.gov/articles/PMC7788469/","evidenceClass":"academic-research","outcomeClass":"mixed","topics":["knowledge-work","infrastructure","data-security","accessibility-workforce","governance-procurement","operating-model"],"finding":"A live randomized trial found no statistically significant improvement in dispatcher cardiac-arrest recognition with AI alerts, despite higher model sensitivity.","sledRelevance":"Interpretation: Historical implementation evidence for current EMS copilot evaluations; not a finding about every contemporary model or U.S. dispatch center.","evidence":"The 2018–2019 trial randomized 5,242 suspected calls; 654 confirmed cases entered the primary analysis. Recognition was 296/318 (93.1%) with alerts versus 304/336 (90.5%) without (P=.15). Model sensitivity was 85.0%, versus dispatchers' 77.5%, but its positive predictive value was lower. Downtime limited processing to 74.7% of received calls.","architectureImplications":"Interpretation: Size real-time audio processing for peak demand and fail safely to standard call handling. Measure availability, alert latency and downstream workflow effects together. Cloud, on-premises and hybrid designs all require outage tests; the study is not a hosting comparison.","governanceImplications":"Interpretation: Medical leadership should approve alert thresholds and evaluate clinical workflow outcomes prospectively. Preserve operator judgment and record overrides without assuming compliance is always desirable.","securityPrivacyImplications":"Interpretation: Recorded emergency speech and clinical linkage require restricted access, lawful processing, retention limits and auditable vendor boundaries.","caveats":"Single setting with medically trained dispatchers; possible learning contamination and insufficient training. Undersized servers caused downtime. Table 2's 93.7% conflicts with 296/318; use the count and abstract's 93.1%. No survival benefit is established.","streamIds":["emergency-services"],"roles":{"sales":"Interpretation — Dispatch leaders and medical directors need to reduce missed emergencies while managing interruptions and finite response capacity. Ask about local recognition baselines, false-alert tolerance, call mix and who reviews adverse events. A credible value hypothesis is that a carefully tuned copilot may improve a specific workflow if tested prospectively. Offer an evaluation-design and readiness engagement that includes clinical quality assurance, frontline staff and IT. Do not quote superior standalone sensitivity as demonstrated human-team improvement or promise lives saved. The Danish setting limits transferability, and current products require their own evidence. Commercial discovery should establish whether the agency can support a controlled pilot and independent review before proposing broad deployment.","engineering":"Interpretation — Integrate a read-only audio branch and advisory display behind existing call handling, retaining an immediate return to normal protocols. Establish consent or other lawful processing, secure outcome linkage and an independently adjudicated reference set before testing. Validate peak concurrency, alert delays, outage recovery and model-version traceability. Use shadow operation to estimate false positives and false negatives, followed by an approved prospective comparison of team performance. Distinguish missed model events from ignored alerts and pipeline failures. Proposed validation includes no delay to the primary call path, measured availability and clinical endpoints agreed by the medical director. Security tests should cover audio exposure, account scope, retention and logs.","delivery":"Interpretation — Name a clinical quality lead, dispatch supervisor and service-reliability owner. Map current recognition and escalation workflows, prepare training, run shadow evaluation and review results before exposing alerts during an authorized pilot. Secure data-sharing dependencies and sufficient reviewer capacity. Governance checkpoints should cover baseline quality, threshold selection, any adverse event and each material model change. Proposed acceptance requires prespecified clinical performance criteria, documented false-alert workload, tested fallback and monitoring of staff adoption without penalizing justified overrides. No threshold here is an observed local result. Risks include alert fatigue, automation bias, selective outcome measurement and outage-induced blind spots; maintain a stop rule and a documented rollback procedure."},"retrievedAt":"2026-09-07T03:00:57Z","enrichedAt":"2026-09-07T03:01:31Z","enrichmentBasis":"retrieved source","accessibilityWorkforceImplications":"Interpretation: Validate local languages, speech conditions and alert usability; train staff on false positives as well as missed events.","procurementImplications":"Interpretation: Require transparent operating-point performance, downtime reporting, model-change notice and a prospective evaluation plan.","operatingModelImplications":"Interpretation: EMS clinical quality assurance owns outcome review; dispatch supervisors own adoption and IT owns continuity.","sourceVerification":{"openedUrl":"https://pmc.ncbi.nlm.nih.gov/articles/PMC7788469/","referenceExcerpt":"the servers analyzing the phone calls had downtime because the server was underdimensioned.","promptVersion":"sled-research-v3.1","model":null,"basis":"agent-reported inspection"}}}]}