From Science to Guidelines: The Future for Resuscitation
1Department of Emergency Medicine Hospital of the University of Pennsylvania Ground Floor, Ravdin Building
DOI: 10.22514/SV51.092010.2 Vol.5,Issue S1,September 2010 pp.10-12
Published: 07 September 2010
The periodic development and publication of treatment guidelines is integral to the field of cardiopulmonary resuscitation and emergency cardiovascular care. The methods for guideline development have evolved over the past few decades, and the process itself has become the subject of increasing scientific investigation. An internationally validated tool for assessing the quality of clinical practice guidelines is The Appraisal of Guidelines for Research and Evaluation (AGREE) instrument. Applying this tool to the ILCOR 2010 International Consensus on CPR (cardiopulmonary resuscitation) and ECC (emergency cardiac care) Science with Treatment Recommendations (CoSTR) and the resulting member council guidelines will be a valuable initial step in evaluating both the process and the product. By doing so, important strengths can be recognized as well as opportunities for improvement moving forward. Beyond validated tools to assess and improve the quality of the traditional guidelines process, a critical reassessment of the overall strategy for improving cardiac arrest outcomes is indi-cated. From the lay-provider perspective, innovative approaches to facilitate performance of bystander CPR are needed. This is likely to entail more individualized instructional methods that are titrated to the provider’s capabilities for learning and performance. What the future might hold for professional providers is a more individualized treatment strategy titrated to real-time physiologic monitoring with mechanized delivery of therapies guided by real-time computer-aided medical decision-making. These individualized instructional and treatment strategies could revolutionize our approach to cardiac arrest resuscitation, and dramatically change how guidelines are developed, implemented and evaluated.
cardiac arrest, cardiop-ulmonary resuscitation, CPR, guide-lines
ROBERT W. NEUMAR. From Science to Guidelines: The Future for Resuscitation. Signa Vitae. 2010. 5(S1);10-12.
1. Cardiopulmonary resuscitation. JAMA 1966;198:372-9.
2. Standards for cardiopulmonary resuscitation (CPR) and emergency cardiac care (ECC). JAMA 1974;227(Suppl1):837-51.
3. Chamberlain DA, Cummins RO. Advisory statements of the International Liaison Committee on Resuscitation ('ILCOR'). Resuscitation 1997;34:99-100.
4. Baskett PJ, Chamberlain D. The ILCOR advisory statements. International Liaison Committee on Resuscitation. Resuscitation 1997;34:97-8.
5. AGREE Collaboration. Development and validation of an international appraisal instrument for assessing the quality of clinical practice guidelines: the AGREE project. Qual Saf Health Care 2003;12:18-23.
6. Anonymous. AGREE Next Steps Consortium. The AGREE II Instrument (electronic version) 2009 (cited 2010 July 10). Available at: http://www.agreetrust.org .
7. Krahn M, Naglie G. The next step in guideline development: incorporating patient preferences. JAMA 2008;23;300:436-8.
8. Tricoci P, Allen JM, Kramer JM, Califf RM, Smith SC Jr. Scientific evidence underlying the ACC/AHA clinical practice guidelines. JAMA 2009;301:831-41.
9. Jacobs V, Nadkarni J, Bahr RA, Berg JE, Billi L Bossaert, Cassan P, et al. Cardiac arrest and cardiopulmonary resuscitation outcome reports: update and simplification of the Utstein templates for resuscitation registries. A statement for healthcare professionals from a task force of the international liaison committee on resuscitation (American Heart Association, European Resuscitation Council, Australian Resuscitation Council, New Zealand Resuscitation Council, Heart and Stroke Foundation of Canada, InterAmerican Heart Foundation, Resuscitation Council of Southern Africa). Resuscitation 2004;63:233–49.
10. Langhelle A, Nolan J, Herlitz J, Castren M, Wenzel V, Soreide E, et al. 2003 Utstein Consensus Symposium. Resuscitation. Recommended guidelines for reviewing, reporting, and conducting research on post-resuscitation care: the Utstein style. Resuscitation 2005;66:271-83.
11. Sayre MR, Berg RA, Cave DM, Page RL, Potts J, White RD. American Heart Association Emergency Cardiovascular Care Committee. American Heart Association Emergency Hands-only (compression-only) cardiopulmonary resuscitation: a call to action for bystander response to adults who experience out-of-hospital sudden cardiac arrest: a science advisory for the public from the American Heart Asso-ciation Emergency Cardiovascular Care Committee. Circulation 2008;117:2162-7.
12. Amit X, Garg AX, Adhikari NK, McDonald H, Rosas-Arellano MP, Devereaux PJ, et al. Effects of computerized clinical decision support systems on practitioner performance and patient outcomes: a systematic review. JAMA 2005 Mar 9;293(10):1223-38.
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