Now that we have the Utstein style, are we using it?

Objectives: To examine the extent to which the Utstein style has been used for out-of-hospital cardiac arrest (OOHCA) research since its publication i n 1991. The style was developed in an effort to standardize OOHCA research and reporting. Methods: To locate all OOHCA research papers published betwe en 1992 and 1997, all issues of six emergency medicine/emergency medical se rvices (EM/EMS) journals were examined manually, and papers from other jour nals were located using computerized searches. All located articles were ex amined by the first author to determine whether use of the Utstein style wa s indicated and if so, whether it had actually been used. When either of th ese was uncertain, all three authors reviewed the paper, and a consensus wa s reached. The Pearson chi-square test was used to compare rates of use fro m U.S. and non-U.S. institutions, and from the EM/EMS and non-EM/EMS litera ture, with significance set at p < 0.05. Results: All 143 OOHCA research ar ticles identified by the search were examined. The Utstein style was found to be not applicable to 41 (29%), and these were eliminated. The Utstein st yle was indicated for the remaining 102 studies. Of these, 41 (40%) used th e Utstein style, and 61 (60%) did not. There was no difference in rates bet ween papers from sites in the United States (18/48, 38%) and elsewhere (23/ 54, 43%), or between papers from the EM/EMS literature (17/44, 39%) and non -EM/EMS literature (25/59, 42%). Despite an upward trend in the use of the Utstein style seen from 1992 to 1994, use leveled off from 1994 to 1997, an d has not exceeded 60% in any given calendar year studied. Conclusions: Six years after the release of the Utstein style for OOHCA research, fewer tha n 60% of OOHCA research articles actually use the style.