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. 2024 Oct 17;5(5):e13334.
doi: 10.1002/emp2.13334. eCollection 2024 Oct.

Evaluating the current breadth of randomized control trials on cardiac arrest: A scoping review

Jake Toy  1   2   3   4 , Lauren Friend  5 , Kelsey Wilhelm  2   3   4 , Michael Kim  1   2   4 , Claire Gahm  6 , Ashish R Panchal  7 , David Dillon  8 , Joelle Donofrio-Odmann  6 , Juan Carlos Montroy  5 , Marianne Gausche-Hill  2   3   4 , Nichole Bosson  1   2   3   4 , Ryan Coute  9 , Shira Schlesinger  1   2   3   4 , James Menegazzi  10
Affiliations

Evaluating the current breadth of randomized control trials on cardiac arrest: A scoping review

Jake Toy et al. J Am Coll Emerg Physicians Open. .

Abstract

Objectives: Despite the significant disease burden due to cardiac arrest, there is a relative paucity of randomized controlled trials (RCTs) to inform definitive management. We aimed to evaluate the current scope of cardiac arrest RCTs published between 2015 and 2022.

Methods: We conducted a search in October 2023 of MEDLINE, Embase, and Web of Science for cardiac arrest RCTs. We included trials published between 2015 and 2022 enrolling human subjects suffering from non-traumatic cardiac arrest. Descriptive statistics were reported and the Mann Kendall test was used to evaluate for temporal trends in the number of trials published annually.

Results: We identified 1764 unique publications, 87 RCTs were included after title/abstract and full-text review. We found no significant increase in trials published annually (eight in 2015 and 16 in 2022, p = 1.0). Geographic analysis of study centers found 31 countries represented; Denmark (n = 13, 15%) and the United States (n = 9, 10%) conducted the majority of trials. Nearly all trials included adults (n = 84, 97%) and few included children (n = 9, 10%). The majority of trials focused on out-of-hospital cardiac arrest (n = 62, 71%). Thirty-eight (44%) trials used an intervention characterized as a process improvement; 28 (32%) interventions were characterized as a drug and 20 (23%) as a device. Interventions were implemented with similar frequency in the prehospital (33%) and intensive care unit (38%) setting, as well as similarly between the intra-arrest (53%) and post-arrest (46%) periods. Twenty (27%) trials selected a primary outcome of survival at ≥ 28 days.

Conclusions: Publication of cardiac arrest RCTs remained constant between 2015 and 2022. We identified significant gaps including a lack of trials examining in-hospital cardiac arrest and pediatric patients.

Keywords: clinical trials as topic; heart arrest; out‐of‐hospital cardiac arrest; random allocation.

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Conflict of interest statement

The authors declare they have no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Flow diagram for studies included from 2015 to 2022. RCT, randomized controlled trial; ROSC, return of spontaneous circulation.
FIGURE 2
FIGURE 2
Frequency of randomized controlled trials published by year. There was no significant increasing or decreasing trend (p = 1).
FIGURE 3
FIGURE 3
Frequency randomized controlled trials by country participation. Note: In multinational collaborations, study sites are represented individually in the counts for each country.
See this image and copyright information in PMC

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