Resuscitation Outcomes Consortium (ROC) PRIMED cardiac arrest trial methods. Part 2: Rationale and methodology for "Analyze Later vs. Analyze Early" protocol

Ian G. Stiell, Clif Callaway, Dan Davis, Tom Terndrup, Judy Powell, Andrea Cook, Peter J. Kudenchuk, Mohamud Ramzan Daya, Richard Kerber, Ahamed Idris, Laurie J. Morrison, Tom Aufderheide

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Objective: The primary objective of the trial is to compare survival to hospital discharge with modified Rankin score (MRS) ≤3 between a strategy that prioritizes a specified period of CPR before rhythm analysis (Analyze Later) versus a strategy of minimal CPR followed by early rhythm analysis (Analyze Early) in patients with out-of-hospital cardiac arrest. Methods: Design-Cluster randomized trial with cluster units defined by geographic region, or monitor/defibrillator machine. Population-Adults treated by emergency medical service (EMS) providers for non-traumatic out-of-hospital cardiac arrest not witnessed by EMS. Setting-EMS systems participating in the Resuscitation Outcomes Consortium and agreeing to cluster randomization to the Analyze Later versus Analyze Early intervention in a crossover fashion. Sample size-Based on a two-sided significance level of 0.05, a maximum of 13,239 evaluable patients will allow statistical power of 0.996 to detect a hypothesized improvement in the probability of survival to discharge with MRS ≤3 rate from 5.41% after Analyze Early to 7.45% after Analyze Later (2.04% absolute increase in primary outcome). Conclusion: If this trial demonstrates a significant improvement in survival with a strategy of Analyze Later, it is estimated that 4000 premature deaths from cardiac arrest would be averted annually in North America alone.

Original languageEnglish (US)
Pages (from-to)186-195
Number of pages10
JournalResuscitation
Volume78
Issue number2
DOIs
StatePublished - Aug 2008
Externally publishedYes

Fingerprint

Emergency Medical Services
Heart Arrest
Resuscitation
Out-of-Hospital Cardiac Arrest
Cardiopulmonary Resuscitation
Survival
Premature Mortality
Defibrillators
Random Allocation
North America
Sample Size
Population

Keywords

  • Cardiac arrest
  • CPR
  • Defibrillation
  • Prehospital

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Nursing(all)

Cite this

Resuscitation Outcomes Consortium (ROC) PRIMED cardiac arrest trial methods. Part 2 : Rationale and methodology for "Analyze Later vs. Analyze Early" protocol. / Stiell, Ian G.; Callaway, Clif; Davis, Dan; Terndrup, Tom; Powell, Judy; Cook, Andrea; Kudenchuk, Peter J.; Daya, Mohamud Ramzan; Kerber, Richard; Idris, Ahamed; Morrison, Laurie J.; Aufderheide, Tom.

In: Resuscitation, Vol. 78, No. 2, 08.2008, p. 186-195.

Research output: Contribution to journalArticle

Stiell, IG, Callaway, C, Davis, D, Terndrup, T, Powell, J, Cook, A, Kudenchuk, PJ, Daya, MR, Kerber, R, Idris, A, Morrison, LJ & Aufderheide, T 2008, 'Resuscitation Outcomes Consortium (ROC) PRIMED cardiac arrest trial methods. Part 2: Rationale and methodology for "Analyze Later vs. Analyze Early" protocol', Resuscitation, vol. 78, no. 2, pp. 186-195. https://doi.org/10.1016/j.resuscitation.2008.01.027
Stiell, Ian G. ; Callaway, Clif ; Davis, Dan ; Terndrup, Tom ; Powell, Judy ; Cook, Andrea ; Kudenchuk, Peter J. ; Daya, Mohamud Ramzan ; Kerber, Richard ; Idris, Ahamed ; Morrison, Laurie J. ; Aufderheide, Tom. / Resuscitation Outcomes Consortium (ROC) PRIMED cardiac arrest trial methods. Part 2 : Rationale and methodology for "Analyze Later vs. Analyze Early" protocol. In: Resuscitation. 2008 ; Vol. 78, No. 2. pp. 186-195.
@article{249ea4da88d94be58a2abe179ad4d9c5,
title = "Resuscitation Outcomes Consortium (ROC) PRIMED cardiac arrest trial methods. Part 2: Rationale and methodology for {"}Analyze Later vs. Analyze Early{"} protocol",
abstract = "Objective: The primary objective of the trial is to compare survival to hospital discharge with modified Rankin score (MRS) ≤3 between a strategy that prioritizes a specified period of CPR before rhythm analysis (Analyze Later) versus a strategy of minimal CPR followed by early rhythm analysis (Analyze Early) in patients with out-of-hospital cardiac arrest. Methods: Design-Cluster randomized trial with cluster units defined by geographic region, or monitor/defibrillator machine. Population-Adults treated by emergency medical service (EMS) providers for non-traumatic out-of-hospital cardiac arrest not witnessed by EMS. Setting-EMS systems participating in the Resuscitation Outcomes Consortium and agreeing to cluster randomization to the Analyze Later versus Analyze Early intervention in a crossover fashion. Sample size-Based on a two-sided significance level of 0.05, a maximum of 13,239 evaluable patients will allow statistical power of 0.996 to detect a hypothesized improvement in the probability of survival to discharge with MRS ≤3 rate from 5.41{\%} after Analyze Early to 7.45{\%} after Analyze Later (2.04{\%} absolute increase in primary outcome). Conclusion: If this trial demonstrates a significant improvement in survival with a strategy of Analyze Later, it is estimated that 4000 premature deaths from cardiac arrest would be averted annually in North America alone.",
keywords = "Cardiac arrest, CPR, Defibrillation, Prehospital",
author = "Stiell, {Ian G.} and Clif Callaway and Dan Davis and Tom Terndrup and Judy Powell and Andrea Cook and Kudenchuk, {Peter J.} and Daya, {Mohamud Ramzan} and Richard Kerber and Ahamed Idris and Morrison, {Laurie J.} and Tom Aufderheide",
year = "2008",
month = "8",
doi = "10.1016/j.resuscitation.2008.01.027",
language = "English (US)",
volume = "78",
pages = "186--195",
journal = "Resuscitation",
issn = "0300-9572",
publisher = "Elsevier Ireland Ltd",
number = "2",

}

TY - JOUR

T1 - Resuscitation Outcomes Consortium (ROC) PRIMED cardiac arrest trial methods. Part 2

T2 - Rationale and methodology for "Analyze Later vs. Analyze Early" protocol

AU - Stiell, Ian G.

AU - Callaway, Clif

AU - Davis, Dan

AU - Terndrup, Tom

AU - Powell, Judy

AU - Cook, Andrea

AU - Kudenchuk, Peter J.

AU - Daya, Mohamud Ramzan

AU - Kerber, Richard

AU - Idris, Ahamed

AU - Morrison, Laurie J.

AU - Aufderheide, Tom

PY - 2008/8

Y1 - 2008/8

N2 - Objective: The primary objective of the trial is to compare survival to hospital discharge with modified Rankin score (MRS) ≤3 between a strategy that prioritizes a specified period of CPR before rhythm analysis (Analyze Later) versus a strategy of minimal CPR followed by early rhythm analysis (Analyze Early) in patients with out-of-hospital cardiac arrest. Methods: Design-Cluster randomized trial with cluster units defined by geographic region, or monitor/defibrillator machine. Population-Adults treated by emergency medical service (EMS) providers for non-traumatic out-of-hospital cardiac arrest not witnessed by EMS. Setting-EMS systems participating in the Resuscitation Outcomes Consortium and agreeing to cluster randomization to the Analyze Later versus Analyze Early intervention in a crossover fashion. Sample size-Based on a two-sided significance level of 0.05, a maximum of 13,239 evaluable patients will allow statistical power of 0.996 to detect a hypothesized improvement in the probability of survival to discharge with MRS ≤3 rate from 5.41% after Analyze Early to 7.45% after Analyze Later (2.04% absolute increase in primary outcome). Conclusion: If this trial demonstrates a significant improvement in survival with a strategy of Analyze Later, it is estimated that 4000 premature deaths from cardiac arrest would be averted annually in North America alone.

AB - Objective: The primary objective of the trial is to compare survival to hospital discharge with modified Rankin score (MRS) ≤3 between a strategy that prioritizes a specified period of CPR before rhythm analysis (Analyze Later) versus a strategy of minimal CPR followed by early rhythm analysis (Analyze Early) in patients with out-of-hospital cardiac arrest. Methods: Design-Cluster randomized trial with cluster units defined by geographic region, or monitor/defibrillator machine. Population-Adults treated by emergency medical service (EMS) providers for non-traumatic out-of-hospital cardiac arrest not witnessed by EMS. Setting-EMS systems participating in the Resuscitation Outcomes Consortium and agreeing to cluster randomization to the Analyze Later versus Analyze Early intervention in a crossover fashion. Sample size-Based on a two-sided significance level of 0.05, a maximum of 13,239 evaluable patients will allow statistical power of 0.996 to detect a hypothesized improvement in the probability of survival to discharge with MRS ≤3 rate from 5.41% after Analyze Early to 7.45% after Analyze Later (2.04% absolute increase in primary outcome). Conclusion: If this trial demonstrates a significant improvement in survival with a strategy of Analyze Later, it is estimated that 4000 premature deaths from cardiac arrest would be averted annually in North America alone.

KW - Cardiac arrest

KW - CPR

KW - Defibrillation

KW - Prehospital

UR - http://www.scopus.com/inward/record.url?scp=46649118629&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=46649118629&partnerID=8YFLogxK

U2 - 10.1016/j.resuscitation.2008.01.027

DO - 10.1016/j.resuscitation.2008.01.027

M3 - Article

C2 - 18487004

AN - SCOPUS:46649118629

VL - 78

SP - 186

EP - 195

JO - Resuscitation

JF - Resuscitation

SN - 0300-9572

IS - 2

ER -