title: Establishing the Aus-ROC Australian and New Zealand out-of-hospital cardiac arrest Epistry.
abstract: BACKGROUND
  Out-of-hospital cardiac arrest (OHCA) is a global health problem with low survival. Regional variation in survival has heightened interest in combining cardiac arrest registries to understand and improve OHCA outcomes. While individual OHCA registries exist in Australian and New Zealand ambulance services, until recently these registries have not been combined. The aim of this protocol paper is to describe the rationale and methods of the Australian Resuscitation Outcomes Consortium (Aus-ROC) OHCA epidemiological registry (Epistry).
  
  
  METHODS
  The Aus-ROC Epistry is designed as a population-based cohort study. Data collection started in 2014. Six ambulance services in Australia (Ambulance Victoria, SA Ambulance Service, St John Ambulance Western Australia and Queensland Ambulance Service) and New Zealand (St John New Zealand and Wellington Free Ambulance) currently contribute data. All OHCA attended by ambulance, regardless of aetiology or patient age, are included in the Epistry. The catchment population is approximately 19.3 million persons, representing 63% of the Australian population and 100% of the New Zealand population. Data are collected using Utstein-style definitions. Information incorporated into the Epistry includes demographics, arrest features, ambulance response times, treatment and patient outcomes. The primary outcome is 'survival to hospital discharge', with 'return of spontaneous circulation' as a key secondary outcome.
  
  
  BACKGROUND
  Ethics approval was independently sought by each of the contributing registries. Overarching ethics for the Epistry was provided by Monash University HREC (Approval No. CF12/3938-2012001888). A population-based OHCA registry capturing the majority of Australia and New Zealand will allow risk-adjusted outcomes to be determined, to enable benchmarking across ambulance providers, facilitate the identification of system-wide strategies associated with survival from OHCA, and allow monitoring of temporal trends in process and outcomes to improve patient care. Findings will be shared with participating ambulance services and the academic community.
authors.affiliation: Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
authors.forename: Ben
authors.identifier: http://orcid.org/0000-0003-3262-5956
authors.initials: B
authors.lastname: Beck
authors.affiliation: Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), Curtin University, Perth, Western Australia, Australia.
authors.forename: Janet
authors.initials: J
authors.lastname: Bray
authors.affiliation: Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia Ambulance Victoria, Doncaster, Victoria, Australia Discipline of Emergency Medicine, University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Karen
authors.initials: K
authors.lastname: Smith
authors.affiliation: Ambulance Victoria, Doncaster, Victoria, Australia.
authors.forename: Tony
authors.initials: T
authors.lastname: Walker
authors.affiliation: Flinders University, Adelaide, South Australia, Australia SA Ambulance Service, Eastwood, South Australia, Australia.
authors.forename: Hugh
authors.initials: H
authors.lastname: Grantham
authors.affiliation: Flinders University, Adelaide, South Australia, Australia SA Ambulance Service, Eastwood, South Australia, Australia.
authors.forename: Cindy
authors.initials: C
authors.lastname: Hein
authors.affiliation: SA Ambulance Service, Eastwood, South Australia, Australia.
authors.forename: Melanie
authors.initials: M
authors.lastname: Thorrowgood
authors.affiliation: St John Ambulance Western Australia, Perth, Western Australia, Australia.
authors.forename: Anthony
authors.initials: A
authors.lastname: Smith
authors.affiliation: St John, Auckland, New Zealand.
authors.forename: Tony
authors.initials: T
authors.lastname: Smith
authors.affiliation: St John, Auckland, New Zealand Auckland University of Technology, Auckland, New Zealand.
authors.forename: Bridget
authors.initials: B
authors.lastname: Dicker
authors.affiliation: Wellington Free Ambulance, Wellington, New Zealand.
authors.forename: Andy
authors.initials: A
authors.lastname: Swain
authors.affiliation: Wellington Free Ambulance, Wellington, New Zealand.
authors.forename: Mark
authors.initials: M
authors.lastname: Bailey
authors.affiliation: Queensland Ambulance Service, Brisbane, Queensland, Australia School of Clinical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia.
authors.forename: Emma
authors.initials: E
authors.lastname: Bosley
authors.affiliation: Queensland Ambulance Service, Brisbane, Queensland, Australia.
authors.forename: Katherine
authors.initials: K
authors.lastname: Pemberton
authors.affiliation: Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia Emergency and Trauma Centre, The Alfred, Melbourne, Victoria, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Cameron
authors.affiliation: University of Washington-Harborview Center for Prehospital Emergency Care, University of Washington, Seattle, Washington, USA.
authors.forename: Graham
authors.initials: G
authors.lastname: Nichol
authors.affiliation: Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), Curtin University, Perth, Western Australia, Australia Discipline of Emergency Medicine, University of Western Australia, Perth, Western Australia, Australia St John Ambulance Western Australia, Perth, Western Australia, Australia.
authors.forename: Judith
authors.initials: J
authors.lastname: Finn
mesh_terms: D000328:Adult; D000552:Ambulances; D001315:Australia; D016887:Cardiopulmonary Resuscitation; D015331:Cohort Studies; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D008297:Male; D009520:New Zealand; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality / Q000628:therapy*; D012042:Registries
keywords: ACCIDENT & EMERGENCY MEDICINE; EPIDEMIOLOGY; Emergency Medical Service; Registry; out-of-hospital cardiac arrest