- Myron L Weisfeldt, William Osler Professor of Medicine, chair (firstname.lastname@example.org)
- Department of Medicine Johns Hopkins University School of Medicine Baltimore, MD
It depends on proper use and future research
Two carefully conducted studies in this issue—one of efficacy (p 23) and the other of cost (p 28)—are very significant cautionary notes to the literature on public access defibrillation. They reinforce two important points from the world literature on this topic: 1) If an intervention shortens the time from witnessed cardiac arrest to defibrillation to less than four minutes or so, remarkably high survival rates are seen. If, in contrast, the intervention results in shortening the time to defibrillation from, say, an average of 13 minutes to an average of 11 minutes, very little improvement in outcomes will be seen. 2) If admission to a hospital is increased by a defibrillation program but discharge rates and long-term survival are not, there will be bad news from conventional costs and effectiveness analyses.
In rural areas, where the …