P1709A comprehensive meta-analysis on the impact of cardiopulmonary resuscitation guideline changes on outcomes after in- and out-of-hospital cardiac arrest
Bibliographic record
Abstract
Abstract Background Studies on international registries report improved outcomes after in- and out-of-hospital cardiac arrest over the last decade. The 2015 resuscitation guidelines incorporate initiatives derived from both guidelines 2005 and 2010, respectively. Purpose In order to assess the impact of these respective updates, we aim to provide the most comprehensive quantitative summary of comparative studies that specifically focused on outcomes before and after guideline updates. Methods PubMed, Web-of-Science, Embase and The Cochrane Libraries were searched for studies that compared clinical outcomes of patients resuscitated in the period before and after introduction of guidelines 2010 and 2005, respectively. Results For studies on guidelines 2010 vs. 2005 (n=6; 1,002 patients), the pooled estimate did not indicate a difference [OR 1.29 (95% CI 0.74–2.25) p=0.372] in return of spontaneous circulation (ROSC). For survival to discharge a significant benefit [OR 1.70 (1.01–2.84) p=0.045] was observed for patients resuscitated according to guideline 2010. As for guidelines 2005 vs. 2000 (n=23; 40,859 patients), the pooled estimates for ROSC, survival to admission, to discharge and favourable neurologic outcome consistently indicated benefit for guideline 2005 [OR 1.21 (1.04–1.42) p=0.014; OR 1.34 (1.09–1.65) p=0.005; OR 1.46 (1.25–1.70) p<0.001; OR 1.35 (1.01–1.81) p=0.040]. Conclusions This comprehensive meta-analysis quantifies the positive impact of resuscitation guideline updates on outcomes and supports the current way of guideline development. While there is robust evidence for improved overall outcomes after guidelines 2005, the 2010 guideline benefit was restricted to improved survival to discharge. In terms of quality control, our findings call for continued initiatives to monitor outcomes after guideline updates. Acknowledgement/Funding None
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.018 | 0.047 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.017 | 0.068 |
| Bibliometrics | 0.005 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".