Interesting story on local officials debating the evidence on emergency response to cardiac arrest.
Unfortunately, the story didn’t discuss the actual evidence! It provided no data about the magnitude of the benefit that might be obtained with the use of this treatment or about the costs involved. It makes a difference whether investment in this technology will results in 1 out of 100 lives saved or 90 out of 100 lives. It would have been helpful to have some information about the costs involved in other approaches and the benefit that might be obtained with them.
Without providing the actual data, it is not possible to make rationale decisions about the relative merit of the cooling approach.
This is an important public policy issue and we applaud the paper for pursuing it But in this case – as with so many of the stories that we review – discussing the EVIDENCE and the quality of the evidence is essential.
There was no information about the costs for the treatment nor the investment in the infrastructure to support the availability of this treatment. Puzzling given the public policy and city/regional planning aspects of the issue.
Although the experts quoted in the story indicated that survival would be improved with the use of this treatment, there was no indication of how many more individuals might survive or might have less brain damage as a result of cooling.
There was no discussion of harms of treatment. The story ended with a plea to provide people who would otherwise die, with something. However since there was no discussion of outcomes with people who were and were not provided this treatment, it is not possible to know whether there are any harms of receiving this treatment. Survival with brain damage could be increased, which could be considered a harm worse than death in some cases. What do the data show?
The story mentioned that there were two, small studies in 2002 that supported the use of this technology. However the story provided no data on the impact of this treatment on survival or quality of life for survivors. Since the whole argument for investing in this technology depends on the amount of benefit, not providing an estimate of what it might be is a major weakness.
The story cited cardiac arrest statistics.
The story provided names and interview material from several clinicians; there was some difference in opinion about the merits for the use of this approach to treatment.
One problem with the reporting was that one clinician who was in favor of the use of this technology was only identified at the very end of the story as having received funding from the company that sells the device in question.
The story listed several alternative infrastructure investments that might contribute to the enhanced survival of individuals who suffer ventricular fibrillation in a non-hospital setting. The story mentioned bystander CPR training programs, defibrillation programs and EMS response as alternative investments to cooling apparatus.
The story would have been much more valuable to readers had it included information about the size of the benefit and the costs involved with each of these as compared to cooling equipment in emergency departments.
The story indicated that availability of this treatment varied around the country.
It’s clear from the story that this is not a new approach.
Because of the numerous sources cited, it’s clear that this story didn’t rely on a news release.