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In Reply As Drs Kwak and Kim note, the Prehospital Acute Neurological Treatment and Optimization of Medical Care in Stroke Study (PHANTOM-S) used randomization by weeks instead of at the patient level, and this was an acknowledged limitation of our study. However, independent of STEMO or control week and independent of actual STEMO availability during STEMO weeks, dispatchers at the dispatch center activated a stroke alarm if stroke was suspected during an emergency call. All patients for whom a stroke alarm was activated were eligible for the study.
Ebinger M, Grittner U, Audebert HJ. Ambulance-Based Thrombolysis in Acute Ischemic Stroke—Reply. JAMA. 2014;312(9):961-962. doi:10.1001/jama.2014.8378