• Fredrik Byrsell, Andreas Claesson, Mattias Ringh, Leif Svensson, Martin Jonsson, Per Nordberg, Sune Forsberg, Jacob Hollenberg, and Anette Nord.
• Department of Medicine, Centre for Resuscitation Science, Karolinska Institutet, Solna, Sweden; SOS Alarm AB, Stockholm, Sweden. Electronic address: fredrik.byrsell@ki.se.
• Resuscitation. 2021 May 1; 162: 218-226.

AimFast recognition of out-of-hospital cardiac arrest (OHCA) by dispatchers might increase survival. The aim of this observational study of emergency calls was to (1) examine whether a machine learning framework (ML) can increase the proportion of calls recognizing OHCA within the first minute compared with dispatchers, (2) present the performance of ML with different false positive rate (FPR) settings, (3) examine call characteristics influencing OHCA recognition.MethodsML can be configured with different FPR settings, i.e., more or less inclined to suspect an OHCA depending on the predefined setting. ML OHCA recognition within the first minute is evaluated with a 1.5 FPR as the primary endpoint, and other FPR settings as secondary endpoints. ML was exposed to a random sample of emergency calls from 2018. Voice logs were manually audited to evaluate dispatchers time to recognition.ResultsOf 851 OHCA calls, the ML recognized 36% (n = 305) within 1 min compared with 25% (n = 213) by dispatchers. The recognition rate at any time during the call was 86% for ML and 84% for dispatchers, with a median time to recognition of 72 versus 94 s. OHCA recognized by both ML and dispatcher showed a 28 s mean difference in favour of ML (P < 0.001). ML with higher FPR settings reduced recognition times.ConclusionML recognized a higher proportion of OHCA within the first minute compared with dispatchers and has the potential to be a supportive tool during emergency calls. The optimal FPR settings need to be evaluated in a prospective study.Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved.

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