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To the Editor: In their Editorial,¹ Drs Sanders and Ewy raise important questions about the scientific consensus process used by the American Heart Association (AHA) and International Liaison Committee on Resuscitation (ILCOR) in determining guidelines for cardiopulmonary resuscitation (CPR). We agree that actual resuscitation performance in and out of the hospital is often suboptimal^2-4 and that more real-world resuscitation research is needed to guide recommendations. We also agree that improving the likelihood of bystander response and quality of CPR are essential to improve outcomes.

The current ILCOR and AHA resuscitation evidence evaluation process includes multiple steps to ensure that recommendations are scientifically based. For the 2005 consensus process, 5 international expert panels selected topics for review. Selection was based on scientific developments and level of controversy. For each topic, 1 or more experts performed a systematic structured review, graded scientific evidence, and drafted recommendations. Worksheets were critiqued by 2 independent . . . [Full Text of this Article]

John E. Billi, MD
jbilli@umich.edu
Department of Internal Medicine
University of Michigan
Ann Arbor

William Montgomery, MD
University of Hawaii
Honolulu

Jerry Nolan, MD
Royal United Hospital
Bath, England

Vinay Nadkarni, MD
Children’s Hospital of Philadelphia
Philadelphia, Pa

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