Evidence map›Paper›PMID 33247025›Full record

ArticleBMJ open2020

Enhancing Prehospital Outcomes for Cardiac Arrest (EPOC) study: sequential mixed-methods study protocol in Michigan, USA.

Rama A Salhi, Sydney Fouche, Peter Mendel, Christopher Nelson, Michael D Fetters, Timothy Guetterman, Jane Forman, Wilson Nham, Jason E Goldstick, Jessica Lehrich and 10 more

Abstract read
In one paragraph

Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–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

4 citing papers in PubMed.

  1. Observational
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Rama A SalhiDepartment of Emergency Medicine, University of Michigan, Ann Arbor, Michigan, USA.ORCID 0000-0002-6533-5878
Sydney FoucheAcute Care Research Unit, Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA.
Peter MendelRAND Corporation, Santa Monica, California, USA.
Christopher NelsonRAND Corporation, Santa Monica, California, USA.
Michael D FettersDepartment of Family Medicine, University of Michigan, Ann Arbor, Michigan, USA.
Timothy GuettermanDepartment of Family Medicine, University of Michigan, Ann Arbor, Michigan, USA.
Jane FormanAcute Care Research Unit, Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA.
Wilson NhamAcute Care Research Unit, Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA.
Jason E GoldstickAcute Care Research Unit, Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA.
Jessica LehrichAcute Care Research Unit, Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA.
Bill ForbushCity of Alpena Fire Department, Alpena County EMS, City of Alpena, Alpena, Michigan, USA.
Samantha IovanAcute Care Research Unit, Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA.
Antony HsuDepartment of Emergency Medicine, Saint Joseph Mercy Health System, Ann Arbor, Michigan, USA.
Theresa A ShieldsDepartment of Emergency Medicine, University of Michigan Health System, Ann Arbor, Michigan, USA.
Robert DomeierDepartment of Emergency Medicine, Saint Joseph Mercy Health System, Ann Arbor, Michigan, USA.
Claude M SetodjiRAND Corporation, Santa Monica, California, USA.
Robert W NeumarDepartment of Emergency Medicine, University of Michigan Health System, Ann Arbor, Michigan, USA.
CARES Surveillance Group
Brahmajee K NallamothuDivision of Cardiovascular Diseases and the Department of Internal Medicine, University of Michigan Health System, Ann Arbor, Michigan, USA.
Mahshid AbirAcute Care Research Unit, Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA mahshida@med.umich.edu.

Funding

Enhancing Pre-Hospital Outcomes for Cardiac Arrest (EPOC)R01HL137964 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI ABIR, MAHSHID, NALLAMOTHU, BRAHMAJEE K · 2017 to 2020
$3.0M
NHLBI NIH HHS R01 HL137964
6 · The paper itself

Abstract

introductionOut-of-hospital cardiac arrest (OHCA) is a common, life-threatening event encountered routinely by first responders, including police, fire and emergency medical services (EMS). Current literature suggests that there is significant regional variation in outcomes, some of which may be related to modifiable factors. Yet, there is a persistent knowledge gap regarding strategies to guide quality improvement efforts in OHCA care and, by extension, survival. The Enhancing Prehospital Outcomes for Cardiac Arrest (EPOC) study aims to fill these gaps and to improve outcomes. METHODS AND ANALYSIS: This mixed-methods study includes three aims. In aim I, we will define variation in OHCA survival to the emergency department (ED) among EMS agencies that participate in the Michigan Cardiac Arrest Registry to Enhance Survival (CARES) in order to sample EMS agencies with high-survival and low-survival outcomes. In aim II, we will conduct site visits to emergency medical systems-including 911/dispatch, police, non-transport fire, and EMS agencies-in approximately eight high-survival and low-survival communities identified in aim I. At each site, key informant interviews and a multidisciplinary focus group will identify themes associated with high OHCA survival. Transcripts will be coded using a structured codebook and analysed through thematic analysis. Results from aims I and II will inform the development of a survey instrument in aim III that will be administered to all EMS agencies in Michigan. This survey will test the generalisability of factors associated with increased OHCA survival in the qualitative work to ultimately build an EPOC Toolkit which will be distributed to a broad range of stakeholders as a practical 'how-to' guide to improve outcomes. ETHICS AND DISSEMINATION: The EPOC study was deemed exempt by the University of Michigan Institutional Review Board. Findings will be compiled in an 'EPOC Toolkit' and disseminated in the USA through partnerships including, but not limited to, policymakers, EMS leadership and health departments.

Indexed as

Emergency Medical DispatchEmergency Medical ServicesOut-of-Hospital Cardiac ArrestCardiopulmonary ResuscitationHumansMichiganTreatment OutcomeACCIDENT & EMERGENCY MEDICINECARDIOLOGYOrganisation of health servicesProtocols & guidelines

Identifiers

PMID33247025
PMCPMC7703417

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.