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Table 1 Characteristics of quantitative and qualitative included studies (n = 65)

From: A patient-safety and professional perspective on non-conveyance in ambulance care: a systematic review

1st author (Year) Country [ref] Design Methods/Data sources Patients (n) Professionals (n)
Alicandro (1995) USA [29] Pre-test post-test Data card, Online database Patients (n = 361) who refused conveyance Not described
Alrazeeni (2016) Saudi Arabia [31] Retrospective, observational Patient care reports Patients (n = 1791) who were not conveyed EMTs
Anderson (2002) Denmark [32] Retrospective, observational Prehospital database, National Patient Register, Central Personal registry, Registry of Causes of Death Patients (n = 1187) with hypoglycaemia MICU physicians
Burstein (1996) USA [56] Prospective, cohort Identifying card, Telephone follow-up Patients (n = 361) who refused medical assistance Emergency physicians (n = 22), ALS and BLS providers
Burstein (1998) USA [57] Prospective, observational 10-point assertiveness scale, ED disposition instrument Patients (n = 130) who refused medical assistance Paramedic medical-control console operators, EMS-crews, Emergency physicians
Burrell (2013) UK [82] Qualitative Topic guided in-depth interviews No patient population included EMT level 2 (n = 1), EMT level (n = 4), Paramedics (n = 5), Paramedic team leaders (n = 4), Emergency care practitioner (n = 1)
Cain (2003) USA [58] Prospective, observational Patient care report, Refusal form Ambulance calls (n = 17,416) Basic & advanced paramedics
Carter (2002) Canada [59] Prospective, observational Telephone calls, Ambulance call reports Patients (n = 100) with hypoglycaemia receiving IV dextrose Paramedics, Emergency medicine senior residents
Chen (1996) Taiwan [60] Prospective, observational Dispatch record, Ambulance run record, ED disposition form Patients (n = 1035) who called an ambulance EMTs
Cone (1995) USA [8] Retrospective, observational Emergency department records, Telephone follow-up, Ambulance call reports, Medical command control forms Patients (n = 85) who refused conveyance Paramedics, Volunteer municipal basic life support units
Deasy (2008) Ireland [61] Prospective observational Data sheets Ambulance calls (n = 263) Emergency Medicine Specialists, Paramedics
Ebrahimian (2014) Iran [83] Qualitative Semi-structured interviews No patient population included EMS staffs (n = 18)
Gerlacher (2001) USA [79] Cross-sectional Patient records Patients (n = 15,409) ≤ 12 years First responder firefighters, EMTs, Paramedics
Goldstein (2015) Canada [33] Retrospective, observational Electronic patient care records Patients (n = 63,067) ≥ 65 years Primary care paramedics, Intermediate care paramedics, Advanced care paramedics
Haines (2006) USA [62] Prospective, observational Telephone follow-up questionnaire, Ambulance records Patients (n = 5336) <21 years ALS-paramedics, Physicians
Halter (2011) UK [84] Qualitative Semi-structured interviews No patient population included EMTs, Paramedics (n = 12)
Hipskind (1997) USA [63] Prospective, observational Ambulance run reports Patients (n = 683) who refused conveyance Paramedics (n ≈ 350)
Højfeld (2014) Denmark [34] Retrospective, observational MECU database, Medical records Mobile emergency care unit runs (n = 15,392) Anaesthesiologists
Jensen (2013) Canada [64] Prospective, observational Data from emergency health services, Patient care records, Databases Ambulance calls (n = 265) for long term care facility patient Extended care paramedics (n = 7), Paramedics
Kahalé (2006) Canada [65] Prospective, observational Ambulance call reports, Hospital charts, Telephone interviews Patients (n = 345) <16 years EMTs, Paramedics
Kamper (2001) USA [35] Retrospective, observational Ambulance run records, ED records, Hospital records Ambulance calls (n = 53,627) Paramedics
Kannikeswaran (2007) USA [36] Retrospective, observational Standardized data extraction sheets Ambulance runs (n = 5976) for children <18 years EMT-Ps, EMT-Bs
Keene (2015) Australia [85] Mixed-methods Structured interviews, Patient care records Patients (n = 33,333) where an ambulance was dispatched Ambulance paramedics, Intensive care paramedics
Key (2003) USA [30] Pre-test post-test Patient/ambulance records Ambulance calls (n = 11,488) Paramedics, EMTs
Knight (2003) USA [37] Retrospective, descriptive State-wide EMS data, State-wide ED data, Death certificate data EMS dispatches (n = 277,221) Not described
Lerner (2003) USA [66] Prospective, observational Telephone interviews Patients (n = 36) with hypoglycaemia EMT-Ps (n = 23)
Magnusson (2016) Sweden [38] Retrospective, observational Patient notes Patients (n = 529) with low priority, uncertain need for ambulance and vague symptoms Ambulance nurses
Marks (2002) UK [9] Retrospective, observational Patient report forms Patients (n = 500) not conveyed EMTs, Paramedics
Mechem (1998) USA [67] Prospective, observational Telephone interviews Ambulance calls (n = 115,135) Nurses, Paramedics
Minhas (2015) Canada [39] Retrospective, cohort EMS patient records, ED patient records Patients (n = 286) 18–65 years with supraventricular tachycardia ALS paramedics
Moss (1998) USA [40] Retrospective, observational Prehospital records EMS responses (n = 6512) Paramedics
Murphy-Jones (2016) UK [86] qualitative, phenomenological Semi-structured interviews No patient population included Paramedics (n = 6)
Newton (2015) South-Africa [68] Prospective, observational Computerized dispatch logs, Patient report forms Ambulance calls (n = 1689) BLS emergency care providers, ILS emergency care providers, ALS emergency care providers
O’Hara (2015) UK [87] Qualitative Reviewing relevant national and local documents (Reports, policies, protocols), Semi-structured interviews, Observations, Digital diaries, Informal interviews, Focus groups, Written notes No patient population included Directors, Managers, Specialist paramedics, Paramedics, Emergency care assistants/technicians/support workers
Persse (2002) USA [69] Prospective, observational Patient care records, Structured telephone interviews Patients (n = 2207) ≥ 65 years Paramedics, EMTs
Peyravi (2013) Iran [41] Retrospective, observational National data registry, Ambulance station data registry Ambulance runs (n = 84,084) Nurses, Paramedics, GPs
Peyravi (2015) Iran [42] Retrospective observational Patient care records, Telephone interviews Ambulance runs (n = 81,999) Not described
Porter (2007) UK [88] Qualitative Focus groups (n = 3) No patient population included Paramedics (n = 25)
Pringle (2005) USA [43] Retrospective, observational EMS reports, Telephone interviews EMS patient encounters (n = 1894) EMT-Bs, Paramedics
Rudolph (2011) Denmark [44] retrospective, observational Medical emergency care unit database, Autopsy reports Patients (n = 4762) with acute opioid overdose Anaesthesiology specialists, ALS providers
Schmidt (2001) USA [70] Prospective, observational Patient records Patients (n = 1433) were an ambulance was dispatched EMT-Ps, EMT-ILSs, EMT-Bs
Schmidt (1998) USA [71] Prospective, observational Structured telephone interview Patients (n = 324) who refused conveyance Paramedics
Schmidt (2000) USA [72] Prospective observational Data sheets Patients (n = 1433) where an ambulance was dispatched EMT-Ps, EMT-ILSs, EMT-Bs
Schmidt (2006) USA [45] retrospective, observational EMS database Ambulance runs (n = 1501) Paramedics
Selden (1990) USA [46] Retrospective, observational Run records Ambulance runs (n = 11,780) Paramedics
Seltzer (2001) USA [47] Retrospective, observational Run records, Structured telephone interviews Patients (n = 89) <18 years who refused conveyance against medical advice EMT-Ds, EMT-Ps
Shaw (2006) UK [81] Mixed methods Patient records Ambulance runs (n = 76,635) Paramedics, EMTs
Simpson (2014a) Australia [74] Prospective, cohort Data sheets, Administrative databases Patients (n = 1610) ≥65 years who have fallen Paramedics
Simpson (2014b) Australia [73] Prospective, cohort Data collection tool, Dispatch system Patients (n = 1610) ≥65 years who have fallen Paramedics (n = 384)
Snooks (2005) UK [89] Qualitative Focus groups No patient population included Paramedics (n = 26)
Snooks (2014) UK [27] CRCT Paramedic records, ED records Patients (n = 779) ≥65 years who have fallen Paramedics (n = 42)
Snooks (2004a) UK [28] Quasi-experimental Patient report forms, ED records, GP records, Questionnaire Patients (n = 797) were an ambulance was dispatched Paramedics (n = 5), EMTs (n = 5)
Socransky (1998) USA [48] Retrospective, observational Patient records, Hospital records Ambulance runs (n = 10,888) Paramedics
Stark (1990) USA [49] Retrospective, observational EMS database Ambulance calls (n = 1715) Paramedics, Physicians
Staudenmayer (2012) USA [50] Retrospective, cohort Population-based injury database Patients (n = 69,413) with a primary diagnosis of ‘injury’ or ‘trauma’ Not described
Strote (2008) USA [75] Prospective, cohort Medical incident report forms, Telephone interviews Patients (n = 2359) with hypoglycaemia EMTs, Paramedics
Stuhlmiller (2005) USA [51] Retrospective, observational On-line medical command audio tapes, Patient run sheets, Non-conveyance sheets On-line medical control calls (n = 137) for patient-initiated refusals Paramedics
Tiedemann (2013) Australia [76] Prospective, cohort Patient records, Questionnaires (e-mail) Patients (n = 2842) ≥70 years who have fallen Paramedics
Tohira (2016a) Australia [53] Retrospective cohort Patient care records, ED information system, Death registry Patients (n = 1238) post-ictal or with hypoglycaemia Paramedics
Tohira (2016b) Australia [52] Retrospective, cohort Patient care records, ED information system, Death registry Patients (n = 127,574) were an ambulance was dispatched Paramedics
Van der Pols (2011) Netherlands [77] Prospective, cohort Patient record, Hospital databases, Dispatch centre database Patients (n = 1842) were an ambulance was dispatched Ambulance nurses
Vilke (1999) USA [54] Retrospective, observational Prehospital database, Death registry Patients (n = 94,466) were an ambulance was dispatched Paramedics
Vilke (2002) USA [78] Prospective, observational Telephone interviews Patients (n = 636) ≥ 65 years and who signed out against medical advise EMTs, EMT-Ps, EMT-Ds
Zachariah (1992) USA [55] Retrospective, observational Patient records, Structured telephone interviews Patients (n = 158) not conveyed Paramedics
Zorab (2015) UK [80] Cross-sectional Questionnaires No patient population included Emergency Care Assistants, Ambulance Technicians, Student Paramedics, Paramedics, Emergency Care Practitioners, Critical Care Paramedics
  1. Abbreviations: ALS Advanced life Support, BLS Basic Life Support, ED Emergency Department, EMD emergency medical department, EMS Emergency Medical Service, EMT Emergency Medical Technician, EMT-B Emergency Medical Technician Basic, EMT-D Emergency Medical Technician Defibrillation, EMT-ILS Emergency Medical Technician Intermediate Life Support, EMT-P Emergency Medical Technician Paramedics, GP general practitioner, ILS Intermediate Life Support, MECU Mobile Emergency Care Unit, MICU Mobile Intensive Care Unit