Evidence map›Paper›PMID 28254836›Full record

ArticleCirculation2017

Optimizing a Drone Network to Deliver Automated External Defibrillators.

Justin J Boutilier, Steven C Brooks, Alyf Janmohamed, Adam Byers, Jason E Buick, Cathy Zhan, Angela P Schoellig, Sheldon Cheskes, Laurie J Morrison, Timothy C Y Chan and 1 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Circulation, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 77 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
77citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

77 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
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  3. Trial
  4. Organ transport via drones: A cold chain Indian innovation.The Indian journal of medical research · 2026
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17 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors.

Justin J BoutilierFrom Department of Mechanical and Industrial Engineering (J.J.B., T.C.Y.C.), Division of Engineering Science (A.J.), Department of Family and Community Medicine (S.C.), and Department of Medicine (L.J.M.), University of Toronto, Ontario, Canada; Department of Emergency Medicine, Queen's University, Kingston, Ontario, Canada (S.C.B.); Rescu, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada (S.C.B., A.B., J.E.B., C.Z., S.C., L.J.M., T.C.Y.C.); Sunnybrook Centre for Prehospital Medicine, Toronto, Ontario, Canada (J.E.B., S.C.); and University of Toronto Institute for Aerospace Studies, Ontario, Canada (A.P.S.).
Steven C BrooksFrom Department of Mechanical and Industrial Engineering (J.J.B., T.C.Y.C.), Division of Engineering Science (A.J.), Department of Family and Community Medicine (S.C.), and Department of Medicine (L.J.M.), University of Toronto, Ontario, Canada; Department of Emergency Medicine, Queen's University, Kingston, Ontario, Canada (S.C.B.); Rescu, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada (S.C.B., A.B., J.E.B., C.Z., S.C., L.J.M., T.C.Y.C.); Sunnybrook Centre for Prehospital Medicine, Toronto, Ontario, Canada (J.E.B., S.C.); and University of Toronto Institute for Aerospace Studies, Ontario, Canada (A.P.S.).
Alyf JanmohamedFrom Department of Mechanical and Industrial Engineering (J.J.B., T.C.Y.C.), Division of Engineering Science (A.J.), Department of Family and Community Medicine (S.C.), and Department of Medicine (L.J.M.), University of Toronto, Ontario, Canada; Department of Emergency Medicine, Queen's University, Kingston, Ontario, Canada (S.C.B.); Rescu, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada (S.C.B., A.B., J.E.B., C.Z., S.C., L.J.M., T.C.Y.C.); Sunnybrook Centre for Prehospital Medicine, Toronto, Ontario, Canada (J.E.B., S.C.); and University of Toronto Institute for Aerospace Studies, Ontario, Canada (A.P.S.).
Adam ByersFrom Department of Mechanical and Industrial Engineering (J.J.B., T.C.Y.C.), Division of Engineering Science (A.J.), Department of Family and Community Medicine (S.C.), and Department of Medicine (L.J.M.), University of Toronto, Ontario, Canada; Department of Emergency Medicine, Queen's University, Kingston, Ontario, Canada (S.C.B.); Rescu, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada (S.C.B., A.B., J.E.B., C.Z., S.C., L.J.M., T.C.Y.C.); Sunnybrook Centre for Prehospital Medicine, Toronto, Ontario, Canada (J.E.B., S.C.); and University of Toronto Institute for Aerospace Studies, Ontario, Canada (A.P.S.).
Jason E BuickFrom Department of Mechanical and Industrial Engineering (J.J.B., T.C.Y.C.), Division of Engineering Science (A.J.), Department of Family and Community Medicine (S.C.), and Department of Medicine (L.J.M.), University of Toronto, Ontario, Canada; Department of Emergency Medicine, Queen's University, Kingston, Ontario, Canada (S.C.B.); Rescu, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada (S.C.B., A.B., J.E.B., C.Z., S.C., L.J.M., T.C.Y.C.); Sunnybrook Centre for Prehospital Medicine, Toronto, Ontario, Canada (J.E.B., S.C.); and University of Toronto Institute for Aerospace Studies, Ontario, Canada (A.P.S.).
Cathy ZhanFrom Department of Mechanical and Industrial Engineering (J.J.B., T.C.Y.C.), Division of Engineering Science (A.J.), Department of Family and Community Medicine (S.C.), and Department of Medicine (L.J.M.), University of Toronto, Ontario, Canada; Department of Emergency Medicine, Queen's University, Kingston, Ontario, Canada (S.C.B.); Rescu, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada (S.C.B., A.B., J.E.B., C.Z., S.C., L.J.M., T.C.Y.C.); Sunnybrook Centre for Prehospital Medicine, Toronto, Ontario, Canada (J.E.B., S.C.); and University of Toronto Institute for Aerospace Studies, Ontario, Canada (A.P.S.).
Angela P SchoelligFrom Department of Mechanical and Industrial Engineering (J.J.B., T.C.Y.C.), Division of Engineering Science (A.J.), Department of Family and Community Medicine (S.C.), and Department of Medicine (L.J.M.), University of Toronto, Ontario, Canada; Department of Emergency Medicine, Queen's University, Kingston, Ontario, Canada (S.C.B.); Rescu, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada (S.C.B., A.B., J.E.B., C.Z., S.C., L.J.M., T.C.Y.C.); Sunnybrook Centre for Prehospital Medicine, Toronto, Ontario, Canada (J.E.B., S.C.); and University of Toronto Institute for Aerospace Studies, Ontario, Canada (A.P.S.).
Sheldon CheskesFrom Department of Mechanical and Industrial Engineering (J.J.B., T.C.Y.C.), Division of Engineering Science (A.J.), Department of Family and Community Medicine (S.C.), and Department of Medicine (L.J.M.), University of Toronto, Ontario, Canada; Department of Emergency Medicine, Queen's University, Kingston, Ontario, Canada (S.C.B.); Rescu, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada (S.C.B., A.B., J.E.B., C.Z., S.C., L.J.M., T.C.Y.C.); Sunnybrook Centre for Prehospital Medicine, Toronto, Ontario, Canada (J.E.B., S.C.); and University of Toronto Institute for Aerospace Studies, Ontario, Canada (A.P.S.).
Laurie J MorrisonFrom Department of Mechanical and Industrial Engineering (J.J.B., T.C.Y.C.), Division of Engineering Science (A.J.), Department of Family and Community Medicine (S.C.), and Department of Medicine (L.J.M.), University of Toronto, Ontario, Canada; Department of Emergency Medicine, Queen's University, Kingston, Ontario, Canada (S.C.B.); Rescu, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada (S.C.B., A.B., J.E.B., C.Z., S.C., L.J.M., T.C.Y.C.); Sunnybrook Centre for Prehospital Medicine, Toronto, Ontario, Canada (J.E.B., S.C.); and University of Toronto Institute for Aerospace Studies, Ontario, Canada (A.P.S.).
Timothy C Y ChanFrom Department of Mechanical and Industrial Engineering (J.J.B., T.C.Y.C.), Division of Engineering Science (A.J.), Department of Family and Community Medicine (S.C.), and Department of Medicine (L.J.M.), University of Toronto, Ontario, Canada; Department of Emergency Medicine, Queen's University, Kingston, Ontario, Canada (S.C.B.); Rescu, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada (S.C.B., A.B., J.E.B., C.Z., S.C., L.J.M., T.C.Y.C.); Sunnybrook Centre for Prehospital Medicine, Toronto, Ontario, Canada (J.E.B., S.C.); and University of Toronto Institute for Aerospace Studies, Ontario, Canada (A.P.S.). tcychan@mie.utoronto.ca.
Rescu Epistry Investigators

Funding

Resuscitation Outcomes Consortium (ROC) Data Coordinating CenterU01HL077863 · NHLBI · UNIVERSITY OF WASHINGTON · PI MAY, SUSANNE · 2004 to 2015
$125.1M
Resuscitation Outcomes Consortium (ROC) Regional Clinical Center-Toronto RegionalU01HL077872 · NHLBI · ST. MICHAEL'S HOSPITAL · PI MORRISON, LAURIE · 2004 to 2015
$1.9M
NHLBI NIH HHS U01 HL077863NHLBI NIH HHS U01 HL077872
6 · The paper itself

Abstract

backgroundPublic access defibrillation programs can improve survival after out-of-hospital cardiac arrest, but automated external defibrillators (AEDs) are rarely available for bystander use at the scene. Drones are an emerging technology that can deliver an AED to the scene of an out-of-hospital cardiac arrest for bystander use. We hypothesize that a drone network designed with the aid of a mathematical model combining both optimization and queuing can reduce the time to AED arrival.

methodsWe applied our model to 53 702 out-of-hospital cardiac arrests that occurred in the 8 regions of the Toronto Regional RescuNET between January 1, 2006, and December 31, 2014. Our primary analysis quantified the drone network size required to deliver an AED 1, 2, or 3 minutes faster than historical median 911 response times for each region independently. A secondary analysis quantified the reduction in drone resources required if RescuNET was treated as a large coordinated region.

resultsThe region-specific analysis determined that 81 bases and 100 drones would be required to deliver an AED ahead of median 911 response times by 3 minutes. In the most urban region, the 90th percentile of the AED arrival time was reduced by 6 minutes and 43 seconds relative to historical 911 response times in the region. In the most rural region, the 90th percentile was reduced by 10 minutes and 34 seconds. A single coordinated drone network across all regions required 39.5% fewer bases and 30.0% fewer drones to achieve similar AED delivery times.

conclusionsAn optimized drone network designed with the aid of a novel mathematical model can substantially reduce the AED delivery time to an out-of-hospital cardiac arrest event.

Indexed as

Models, TheoreticalAgedCardiopulmonary ResuscitationDefibrillatorsEmergency Medical ServicesFemaleHumansMaleMiddle AgedOntarioOut-of-Hospital Cardiac ArrestTime-to-Treatmentautomated external defibrillatorscardiac arrestdroneoptimizationresuscitation

Identifiers

PMID28254836
PMCPMC5516537

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.