Evidence map›Paper›PMID 41915716›Full record

Trial reportPLoS medicine2026

Machine learning assisted differentiation of low acuity patients at dispatch: The MADLAD randomized controlled trial.

Douglas Nils Spangler, Simon Morelli, David Smekal, Lennart Edmark, Hans Blomberg

Registry-linked trialAbstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in PLoS medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04757194 (Machine Learning Assisted Differentiation of Low Acuity Patients at Dispatch), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04757194 nacompletednot on this map

Machine Learning Assisted Differentiation of Low Acuity Patients at Dispatch: A Randomized Controlled Trial

TypeinterventionalSponsorUppsala University HospitalRan2021 to 2024Enrolled2,499ConditionsEmergenciesArmsopenTriage - Alitis algorithm
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Douglas Nils SpanglerDepartment of Surgical Sciences, Uppsala University, Uppsala, Sweden.ORCID https://orcid.org/0000-0001-6775-5051
Simon MorelliCentre for Clinical Research, Västmanland Hospital, Västerås, Sweden.
David SmekalDepartment of Surgical Sciences, Uppsala University, Uppsala, Sweden.ORCID https://orcid.org/0000-0002-3563-6450
Lennart EdmarkDepartment of Surgical Sciences, Uppsala University, Uppsala, Sweden.ORCID https://orcid.org/0000-0002-7654-3285
Hans BlombergDepartment of Surgical Sciences, Uppsala University, Uppsala, Sweden.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundResource Constrained Situations (RCS) at Emergency Medical Dispatch centers where there are more patients requiring an ambulance than there are available ambulances are common. Machine Learning (ML) techniques offer a promising but largely untested approach to assessing relative risks among these patients. The study aims to establish whether the provision of ML-based risk scores predicting patient outcomes improves the ability of dispatchers to identify patients at high risk for deterioration in RCS and dispatch the first available ambulance to them. METHODS AND

findingsWe performed a parallel-group, randomized trial of adult patients assessed by a dispatch nurse at two study sites in Sweden as requiring a low-priority ambulance response in RCS. Patients were randomized 1:1 to be prioritized with the aid of an ML-based risk assessment tool, or per current clinical practice. The primary outcome was defined in terms of whether the first available ambulance was sent to the patient with the highest National Early Warning Score (NEWS 2) based on subsequently collected vital signs. A total of 1,245 RCS were included in the study. In the intervention arm, 68.3% of RCS were assessed correctly per the primary outcome versus 62.5% in the control group, corresponding to an odds ratio of 1.28 (95% CI [1.00, 1.63], p = 0.047). This study was limited to only patients determined to require a low-priority ambulance response in two Swedish regions, and was underpowered for the primary outcome due to a smaller than expected sample size.

conclusionThis study suggests that clinical ML-based decision support tools may have the ability to influence care provider decisions and improve their capacity to rapidly differentiate between high- and low-risk patients at dispatch. Further research should establish the suitability of these tools in larger cohorts, for patients with both higher- and lower-levels of priority, and in other settings. The trial was registered at ClinicalTrials.gov (NCT04757194).

Indexed as

Emergency Medical DispatchMachine LearningPatient AcuityAgedAmbulancesFemaleHumansMaleMiddle AgedPredictive Learning ModelsRisk AssessmentSwedenTriage

Identifiers

PMID41915716
PMCPMC13037975

What Socratic holds

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LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.