PROSPERO International prospective register of systematic reviews
A systematic review of gender differences in access to key post arrest care interventions for out-of-hospital cardiac arrest patients
Victoria M. Sparrow-Downes, Precilla Veigas, Carolyn Ziegler, Laurie J. Morrison, Valeria E. Rac
Citation
Victoria M. Sparrow-Downes, Precilla Veigas, Carolyn Ziegler, Laurie J. Morrison, Valeria E. Rac. A systematic review of gender differences in access to key post arrest care interventions for out-of-hospital cardiac arrest patients.
PROSPERO
2012:CRD42012003096
Available from http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42012003096
Review question(s)
Are there gender differences in access to key post arrest care interventions for adult out-of-hospital cardiac arrest patients?
The primary objective of this systematic review is to summarize the literature available regarding gender differences in access to key post arrest care interventions for adult out-of-hospital cardiac arrest (OHCA) patients.
The secondary objective of this review is to identify any existing gender differences and/or knowledge gaps that may exist.
Searches
We have searched the MEDLINE, EMBASE, COCHRANE and EBM Reviews databases. Grey literature and clinicaltrials.gov have also been searched and a hand search has been completed.
Studies published prior to 1990 will be excluded. No restrictions have been placed on the language or location of the studies included in the review.
Types of study to be included
Observational studies and randomized controlled trials (RCTs) will be included in the review.
Commentaries, editorials, letters, case reports, animal studies, and other systematic reviews will be excluded.
Condition or domain being studied
85% of all cardiac arrests occur in the prehospital setting, and less than 10% of these patients will survive the event. Preliminary analysis of 5000 OHCA patients indicates that more women survive to hospital admission, but survival to discharge rates are lower when compared with men. These findings suggest that, subsequent to hospital admission, women may be receiving differential treatment (reduced access to post arrest interventions) which is impacting their chances of survival.
Participants/ population
Adults (18 years or older) who have suffered nontraumatic OHCAs. Studies including animals or children as subjects have been excluded.
Intervention(s), exposure(s)
Access to the following key post arrest care interventions will be reviewed:
• Therapeutic Hypothermia.
• Angiography with Percutaneous Coronary Intervention (PCI) if needed.
• Implantable Cardiac Defibrillator (ICD).
• Bypass Surgery.
• Early access to cardiology and neurology consultation.
• Neuroprognostication for greater than or equal 72 hours.
Comparator(s)/ control
Access to post arrest care between adult women and adult men who suffered nontraumatic OHCAs will be compared.
Context
No limits were placed on the location or the language of the studies to be included in the review.
Outcome(s)
Primary outcomes
The primary outcome is access to the following key post arrest care interventions:
• Therapeutic Hypothermia.
• Angiography with Percutaneous Coronary Intervention (PCI) if needed.
• Implantable Cardiac Defibrillator (ICD).
• Bypass Surgery.
• Early access to cardiology and neurology consultation.
• Neuroprognostication for >= 72 hours.
Not applicable.
Secondary outcomes
None.
Data extraction, (selection and coding)
Two independent reviewers (VSD, PD) will use a hierarchical screening method to select the papers to be included in the systematic review based upon preestablished inclusion and exclusion criteria. Any discrepancies in the screening process will be resolved by the senior author (VR) if the two independent reviewers cannot reach a consensus.
Risk of bias (quality) assessment
Quality of individual studies will be assessed using a quality measure scale. We are in the process of determining which quality measure scale will be used.
Strategy for data synthesis
Work in progress.
Analysis of subgroups or subsets
None planned.
Dissemination plans
Results will be published in an academic journal and will be presented at oral and poster conferences.
Contact details for further information
Dr. Valeria Rac
Toronto Health Economics and Technology Assessment (THETA) Collaborative
Leslie Dan Pharmacy Building
University of Toronto
6th Floor, Room 658
144 College Street
Toronto, Ontario
Canada
M5S 3M2
valeria.rac@theta.utoronto.ca
Organisational affiliation of the review
Toronto Health Economics and Technology Assessment (THETA) Collaborative
http://theta.utoronto.ca/
Review team
Ms Victoria M. Sparrow-Downes, St. Michael's Hospital - RESCU Ms Precilla Veigas, St. Michael's Hospital - RESCU Ms Carolyn Ziegler, St. Michael's Hospital - RESCU Dr Laurie J. Morrison, University of Toronto, St. Michael's Hospital - RESCU Dr Valeria E. Rac, University of Toronto, St. Michael's Hospital
Details of any existing review of the same topic by the same authors
Not applicable.
Anticipated or actual start date
01 June 2012
Anticipated completion date
31 December 2012
Funding sources/sponsors
Canadian Institutes of Health Research (CIHR), Heart and Stroke Foundation of Canada, St. Michael's Hospital - RESCU
Conflicts of interest
None known
Other registration details
Not applicable.
Language
English
Country
Canada
Subject index terms status
Subject indexing assigned by CRD
Subject index terms
Health Behavior; Heart Arrest; Humans; Secondary Prevention; Sex Factors
Reference and/or URL for protocol
Not applicable.
Date of registration in PROSPERO
15 October 2012
Date of publication of this revision
17 October 2012
Details of final report/publication(s)
Not applicable.
Stage of review at time of this submission
Started
Completed
Preliminary searches
No
Piloting of the study selection process
Formal screening of search results against eligibility criteria
Data extraction
Risk of bias (quality) assessment
Data analysis
Prospective meta-analysis
PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites.
