Assessment of a Smartphone App to Assist Patients in Identification of Neurological and Cardiac Emergencies: The Emergency Call for Heart Attack And Stroke (ECHAS) Study

Abstract Failure to recognize symptoms of neurological and cardiac emergencies lead to prehospital delays and reduced access to efficacious therapies. We created a smartphone application to help individuals to recognize symptoms requiring emergency evaluation for stroke or myocardial infraction (MI). ECHAS assesses the risk of stroke, MI, or related conditions through evidence-based questions and finger-tapping test. Here, in patients who presented with stroke or MI symptoms to the Emergency Department (ED), we tested the sensitivity of ECHAS to identify patients in whom ED evaluation was appropriate. In 202 patients (57 stroke, 145 MI), ECHAS had 0.98 sensitivity for identifying such patients and 1.0 sensitivity for identifying patients who were admitted to the hospital. Patients reported that the app was fast and usable, taking 111 seconds (SD 60) for stroke and 60 seconds (SD 33) for MI. ECHAS is a sensitive and usable digital medicine tool that now needs prospective clinical validation.