Cochrane corner: Are mechanical compressions better than manual compressions in cardiac arrest?
Bibliographic record
Abstract
The quality of cardiopulmonary resuscitation (CPR) is associated with the probability of survival in people experiencing sudden cardiac arrest.1 Features of CPR quality associated with clinical outcomes include compression rate, compression depth and compression fraction (the proportion of time during a resuscitation attempt when chest compressions are being provided). Evidence suggests that chest compression quality can suffer because of suboptimal team leadership, provider fatigue or distraction with other resuscitation activities (eg, airway management, patient transfer, pulse checks).1 Mechanical chest compression devices have been developed to provide more consistent high quality chest compressions. Devices available on the market today use one of two fundamental mechanisms to facilitate chest compression. Some employ a piston mechanism positioned over the sternum. The LUCAS device, which employs a piston, also includes a suction cup interface with the chest wall to allow active decompression during the recoil phase of the duty cycle. Other devices, namely the ZOLL Autopulse, use a load-distributing band which encircles the chest of the patient. Activation of the device causes a rhythmic shortening and lengthening of the band to compress the chest circumferentially. Early evidence, including animal studies and observational studies in humans suggested that mechanical chest compression devices might be superior to conventional manual chest compressions during cardiac arrest.2 However, there has always been a concern that the devices may cause injury (eg, internal organ trauma) or may introduce dangerous interruptions in chest compressions while they are being deployed during resuscitation attempts. Several clinical trials have been published to explore the effectiveness of mechanical chest compression devices compared with standard manual compressions during cardiac arrest. Our Cochrane systematic review sought to evaluate these clinical trials and determine the relative effectiveness of these two strategies for cardiac arrest.2 We performed a systematic review by searching the following databases: …
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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 | 0.003 | 0.029 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.007 | 0.004 |
| Bibliometrics | 0.003 | 0.004 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.005 | 0.004 |
| Insufficient payload (model declined to judge) | 0.078 | 0.006 |
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".