Moving toward uniform reporting and terminology.
Researchers interested in performing research on prehospital cardiac arrest should carefully review the presentations from the session "Moving Toward Uniform Reporting and Terminology." Although each presentation concentrates on specific research topics, taken together they suggest the next evolutionary steps we should take to conduct such research. We will base these further steps on the following insights. First, all future articles on prehospital cardiac arrest must share a common nomenclature and template for reporting outcomes. The Utstein style has not solved this problem completely, but it is the critical first step. Over the coming years, we must, through continued use, progressively refine the Utstein style. Second, we can no longer depend on research that comes from a single EMS system. Although we have gained important insights from such studies in the past, our expectations of greater validity and generalizability are rising and pushing us toward multicenter, cooperative studies. The International Brain Resuscitation clinical trials and the numerous studies on thrombolytic therapy demonstrate the directions we must head. Third, we must abandon our narrow focus on the pre-hospital experience. Although some studies have avoided this problem, the preponderance of clinical studies on prehospital cardiac arrest fails to gather information on the prearrest condition of the patient, the actual decisions and action taken around the event (witness Kellermann's discussion of death criteria and rules for stopping resuscitation efforts), and the clinical experience after successful resuscitations. Fourth, we can no longer be satisfied with simple statistics on dichotomous (yes/no) survival.(ABSTRACT TRUNCATED AT 250 WORDS)
Cummins
R O
RO
Department of Medicine, University of Washington, Seattle.
D003625:Data Collection / Q000592:standards; D016208:Databases, Factual; D004632:Emergency Medical Services / Q000592:standards*; D006323:Heart Arrest / Q000453:epidemiology / Q000628:therapy; D006801:Humans; D011996:Records / Q000592:standards; D012106:Research / Q000592:standards; D012151:Resuscitation / Q000592:standards* / Q000706:statistics & numerical data; D009626:Terminology as Topic