Top Things to Know: ILCOR COSCA (Core Outcome Set for Cardiac Arrest) in Adults

Top Things to Know: COSCA in Adults

1. In the United States, approximately 360,000 cardiac arrests are attended by emergency services each year, with only 10.6% of patients surviving to hospital discharge.
2. Clinical trials provide essential evidence of the relative benefit of an intervention for stakeholders as diverse as clinicians, patients, and policy makers.
3. A lack of consistency in outcome reporting between trials limits the opportunities to pool results for meta-analysis.
4. The Core Outcome Set for Cardiac Arrest (COSCA) initiative, a partnership between patients, their partners, clinicians, research scientists, and the International Liaison Committee on Resuscitation, sought to develop a consensus core outcome set for cardiac arrest for effectiveness trials.
5. The consensus process involved four steps – (1) systematic review of the literature and interviews with patients (2) Delphi process involving clinicians and patients (3) international expert and patient panel meeting (4) synthesis of findings and recommendations for measurement tools.
6. Consensus emerged that a core outcome set for reporting on effectiveness studies of cardiac arrest (COSCA) in adults should include survival, neurologic function, and health-related quality of life.
7. Should be reported as survival status and modified Rankin scale score at hospital discharge, at 30 days, or both.
8. Health-related quality of life should be measured by using one or more tools from Health Utilities Index version 3, Short-Form 36-Item Health Survey, EuroQol 5D-5L at 90 days and at periodic intervals up to 1 year after cardiac arrest, if resources allow.
9. Further research is needed to identify better measurement tools to capture relevant outcomes following cardiac arrest and refine the most efficient statistical approaches to analysis.
10. The use of a core outcome set for cardiac arrest comprised of survival, neurological function and health related quality of life should improve consistency of reporting and analysis of cardiac arrest effectiveness trials.

Top Things to Know: ILCOR Scientific Knowledge Gaps and Clinical Research Priorities for CPR and ECC

1. Focused account of resuscitation science knowledge gaps identified during/following the 2015 ILCOR evidence evaluation process with publication of the 2015 Update for the Consensus on Science with Treatment Recommendations (CoSTR).
2. The paper describes a total of 24 knowledge gaps in the field of resuscitation science. For each knowledge gap there is a discussion of new data since the 2015 CoSTR publication, and identification of relevant, key research studies in progress.
3. Despite tremendous progress in the field of resuscitation medicine, multiple knowledge gaps remain. This Consensus Statement has outlined the major topic areas and attempted to prioritize the gaps in knowledge, based on potential impact on outcomes and feasibility to perform.
4. The writing group hopes that by directing research efforts toward areas of high priority and impact, there will be future progress in resuscitation outcomes.