The performance parameters of “diagnostic tests” carried out during telephone assessments at emergency medical communication centres appear to be poor, with low levels of sensitivity and specificity. The aims of this scoping review were threefold: i) to assess the progress in measuring the accuracy of emergency medical dispatch and remote triage, by examining recent studies that met the required diagnostic accuracy criteria; ii) to identify whether or not a consensus on common reporting standards had emerged or at least a trend as to how to measure the accuracy of emergency medical dispatch; and iii) to propose a standardised reporting process and means of interpreting diagnostic performance parameters.

The scientific articles included in this review were selected using a systematic approach (PRISMA) applied to the PubMed® bibliographic database over the last seven-years. To meet the inclusion criteria, all the criteria required to measure diagnostic accuracy had to be reported. A QUADAS-2 bias and applicability analysis, and a GRADE certainty of evidence assessment were performed. A narrative synthesis of this systematic review was then provided.

This review included 53 studies that met all the criteria required to measure the accuracy of a diagnostic index test, some of which involve very large populations. Just under half of these studies were related to the COVID19 pandemic, the development of call centres for out-of-hours services - primary care and machine learning systems. Most of studies, however, remained focused on measuring the accuracy of dispatch systems, OHCA, stroke, chest pain and trauma. Few studies have formally followed the STARD guidelines, but despite this, their quality has improved considerably.

By emphasizing the importance of the prevalence of the target condition for interpreting the diagnostic tests results, we were now in a position to propose complementary elements to STARD, the aim of which was to establish standardised reporting on the accuracy of emergency medical dispatch. This standardised reporting included i) compliance with three mandatory conditions concerning the population included and ii) the choice of a single index test and a single associated reference standard from the five proposed. This scoping review therefore suggests ways of reducing the heterogeneity of test performance parameters and proposes criteria for improving the comparability of studies on diagnostic accuracy in emergency medical service dispatch and remote triage.