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. 2025 Jul 25;15(7):e094869.
doi: 10.1136/bmjopen-2024-094869.

Deconstructing resuscitation training for healthcare providers: a protocol for a component network meta-analysis

Defi Efendi  1   2   3 , Adam Cheng  4   5 , Dessie Wanda  1 , Toshi A Furukawa  6 , Maria Petropoulou #  7 , Orestis Efthimiou #  8 , Kee-Hsin Chen  9   10   11   12 ; LIFESAVERS (Leading Innovations for Emergency Support and Vital Enhancements in Resuscitation Simulation) study network
Collaborators, Affiliations

Deconstructing resuscitation training for healthcare providers: a protocol for a component network meta-analysis

Defi Efendi et al. BMJ Open. .

Abstract

Introduction: The necessity of enhancing resuscitation training has been encouraged by The International Liaison Committee on Resuscitation and the American Heart Association to reduce mortality, disability and healthcare costs. Resuscitation training is a complicated approach that encompasses various components and their mixture. It is essential to identify the most effective of these components and their combinations, to measure the corresponding effect size and to understand which participant groups may enjoy the greatest advantage.

Methods and analysis: We will systematically search 12 databases and two clinical trial registries for randomised controlled trials (RCTs) that examine different resuscitation training methods from inception to April 2025. The analysis will be carried out using the standard network meta-analysis and component network meta-analysis models. Resuscitation skills of staff will be the primary outcome of this analysis. Paired reviewers will independently screen and extract data. A consensus will be sought with the principal investigators to resolve any disagreements that cannot be achieved through regular meetings. Each intervention in each RCT will be decomposed according to its constituent components, such as delivery method, interactivity, teamwork, digitalisation and type of simulator. The analysis will be conducted using the frequentist and bayesian approach in the R environment. RoB V.2.0 and Confidence in Network Meta-Analysis will, respectively, be used to assess the risk of bias and the certainty of the evidence.

Ethics and dissemination: As we will use only aggregated secondary data without individual identities, ethical approval is not required. Results of this review will be shared through a peer-reviewed publication and presentation of papers at any relevant conferences.

Prospero registration number: CRD42024532878.

Keywords: Cardiopulmonary Resuscitation; EDUCATION & TRAINING (see Medical Education & Training); Health Care Costs; Network Meta-Analysis; Systematic Review.

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Conflict of interest statement

Competing interests: AC is the director and faculty member for the Debriefing Academy, which runs courses for healthcare simulation educators. TAF reports obtaining personal fees from Boehringer-Ingelheim, Daiichi Sankyo, DT Axis, Kyoto University Original, Micron, Shionogi, SONY, and UpToDate, and a grant from DT Axis and Shionogi, outside the submitted work. In addition, TAF has a patent, number 7448125, and a pending patent, number 2022-082495, and has licensed intellectual properties for Kokoro-app to Mitsubishi-Tanabe. MP is funded by the Deutsche Forschungsgemeinschaft (DFG), grant number: 504730171. The rest of the authors declare that there is no conflict of interest.

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References

    1. Mundell WC, Kennedy CC, Szostek JH, et al. Simulation technology for resuscitation training: a systematic review and meta-analysis. Resuscitation. 2013;84:1174–83. doi: 10.1016/j.resuscitation.2013.04.016. - DOI - PubMed
    1. Meaney PA, Bobrow BJ, Mancini ME, et al. Cardiopulmonary resuscitation quality: [corrected] improving cardiac resuscitation outcomes both inside and outside the hospital: a consensus statement from the American Heart Association. Circulation. 2013;128:417–35. doi: 10.1161/CIR.0b013e31829d8654. - DOI - PubMed
    1. Sandroni C, Nolan J, Cavallaro F, et al. In-hospital cardiac arrest: incidence, prognosis and possible measures to improve survival. Intensive Care Med . 2007;33:237–45. doi: 10.1007/s00134-006-0326-z. - DOI - PubMed
    1. Andersen LW, Holmberg MJ, Løfgren B, et al. Adult in-hospital cardiac arrest in Denmark. Resuscitation . 2019;140:31–6. doi: 10.1016/j.resuscitation.2019.04.046. - DOI - PubMed
    1. Holmberg MJ, Ross CE, Fitzmaurice GM, et al. Annual Incidence of Adult and Pediatric In-Hospital Cardiac Arrest in the United States. Circ Cardiovasc Qual Outcomes. 2019;12:10.1161/CIRCOUTCOMES.119.005580. doi: 10.1161/CIRCOUTCOMES.119.005580. - DOI - PMC - PubMed