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Lessons From Externally Controlled Trials

Carin M. Olson, MD; Phil B. Fontanarosa, MD

JAMA. 1999;281:1220-1222.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

At least 250,000 people experience sudden cardiac death outside of hospitals each year in the United States.¹ Despite application of techniques ranging from basic cardiopulmonary resuscitation (CPR), through "first responder" defibrillation using automatic external defibrillators, to advanced cardiac life support (including airways and drugs) by emergency medical service (EMS) personnel, survival rates for out-of-hospital cardiac arrest are as low as 1.4%,² although rates vary widely.³ Even more troublesome than the low survival rates is the difficulty in maximizing the functional ability of those who survive. Clearly, any process that is as widely applicable but has such poor success as resuscitation needs continuous reevaluation and evidence-based strategies for improvement.

In this issue of THE JOURNAL, 2 groups of investigators present their attempts to improve survival for out-of-hospital cardiac arrest. The study by Stiell et al,⁴ conducted in 19 Ontario communities representing 2.7 million . . . [Full Text of this Article]

Author Affiliations: Dr Olson is a Contributing Editor and Dr Fontanarosa is interim Coeditor of JAMA.

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