ECC Data Analysis & Reporting 2 — Questions and Answers
Question 1: In a cardiac arrest registry, which metric best reflects the quality of post-resuscitation care?
- Return of spontaneous circulation (ROSC) rate
- Survival to hospital discharge with favorable neurological outcome (Correct answer)
- Time to first defibrillation
- Bystander CPR rate
Correct answer: Survival to hospital discharge with favorable neurological outcome
Survival to hospital discharge with favorable neurological outcome (CPC 1-2) is the gold-standard outcome metric because it captures both survival and meaningful recovery.
Question 2: A hospital's Utstein-style report shows a 10% gap between ROSC rate and survival to discharge. This gap most likely reflects deficiencies in:
- Pre-hospital CPR quality
- Time to defibrillation
- Post-resuscitation care protocols (Correct answer)
- Dispatcher-assisted CPR rates
Correct answer: Post-resuscitation care protocols
The gap between ROSC and discharge survival is largely attributable to post-resuscitation care quality, including targeted temperature management and hemodynamic optimization.
Question 3: When analyzing EMS response time data, which statistical measure is most appropriate for a dataset with significant outliers?
- Mean
- Median (Correct answer)
- Mode
- Range
Correct answer: Median
Median is preferred over mean for skewed datasets with outliers because it represents the central value without being distorted by extreme values.
Question 4: A QI committee notes that CPR compression fraction improved from 55% to 72% over 12 months. Which data source is most reliable for measuring CPR compression fraction?
- Manual event documentation
- Verbal team debriefs
- Accelerometer-equipped defibrillator download data (Correct answer)
- Witness bystander reports
Correct answer: Accelerometer-equipped defibrillator download data
Accelerometer data from code-capable defibrillators provides objective, time-stamped CPR quality metrics including compression fraction, rate, and depth.
Question 5: Which Utstein variable is used to stratify OHCA outcomes to enable meaningful hospital-to-hospital comparisons?
- Patient age
- Witnessed status and initial rhythm (Correct answer)
- EMS crew experience level
- Time of day of arrest
Correct answer: Witnessed status and initial rhythm
Witnessed status and initial rhythm (shockable vs. non-shockable) are core Utstein stratifiers that allow risk-adjusted outcome comparisons across systems.
Question 6: A data analyst finds that a hospital's STEMI door-to-balloon time average is 62 minutes, but the 90th percentile is 110 minutes. What does this distribution suggest?
- The average is misleading; a subset of cases have significantly delayed treatment (Correct answer)
- The hospital consistently meets the 90-minute benchmark
- Outliers do not affect overall performance
- The median is likely above 90 minutes
Correct answer: The average is misleading; a subset of cases have significantly delayed treatment
A mean of 62 minutes with a 90th percentile of 110 minutes indicates right skew — most cases are fast but a significant minority experience dangerous delays.
Question 7: In cardiac arrest quality improvement, which concept describes tracking the chain of survival as a series of time-interval metrics?
- Crew resource management scoring
- Utstein time point analysis (Correct answer)
- Case mix adjustment
- Process control charting
Correct answer: Utstein time point analysis
Utstein time point analysis defines discrete time intervals (collapse to call, call to CPR, CPR to defibrillation) enabling identification of where delays occur in the chain of survival.
ECC Data Analysis & Reporting 2
In a cardiac arrest registry, which metric best reflects the quality of post-resuscitation care?