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Collaboration in pre-hospital care research: the pan asian resuscitation outcomes study

01 March 2012
Volume 2 · Issue 1

Abstract

The Pan-Asian Resuscitation Outcomes Study (PAROS) Clinical Research Network is a unique, low-cost, self-funded model of a collaborative research network in the Asia-Pacific region formed in 2010. Currently, research into pre-hospital and emergency care in the Asia-Pacific region is largely inadequate and poorly coordinated owing to the marked variations in Emergency Medical Services (EMS) systems and outcomes reporting. With conditions such as Out-of-Hospital Cardiac Arrest (OHCA) being one of the leading causes of death worldwide, the dearth in the understanding of trends and research in pre-hospital and emergency care underscores the urgent need for more collaborative research in this area. By creating a platform to connect serious researchers, PAROS Clinical Research Network fosters an environment conducive for intellectual exchanges and for research ideas to be shared and implemented. This article describes the enablers pertaining to governance, frameworks and people in the formation and development of the PAROS Clinical Research Network. The Network has concentrated on building a supportive environment through having proper governance structure, efforts to harmonize the data dictionary for the registry, supportive frameworks that promote ethical and proper collection and use of data, and efforts in seeking opportunities to educate and equip its members with relevant knowledge and research capabilities. These descriptions are presented to provide a research framework for others in the field and to increase international collaboration for research in pre-hospital and emergency care.

Out-of-hospital cardiac arrest (OHCA) is a leading healthcare concern. The ever-increasing and progressively aging population is expected to contribute to the increasing strain on emergency medical services (EMS) systems and healthcare infrastructures for emergency medical conditions including OHCA.

Today, published OHCA incidences and outcomes vary greatly around the globe. OHCA survival-to-discharge rate for Asia stands at a dismal 2% as compared to 6%, 9%, and 11% for North America, Europe, and Australia respectively (Berdowski et al, 2010). Even when available, data from most of the Asia-Pacific region has been largely inadequate and uncoordinated unlike the Cardiac Arrest Registry to Enhance Survival (CARES) in the United States, the Canadian Ontario Prehospital Advanced Life Support (OPALS) network and the Resuscitation Outcomes Consortium (ROC) of North America. These regional registries have produced research impacting policies and serve as models for the Asia-Pacific region. Without a similar regional effort in the Asia-Pacific region to capture and measure OHCA outcomes, it is difficult to systematically deduce ways to improve survival in a part of the world where OHCA survival rates are one of the lowest globally. Owing a large part to the inherently complex and uncontrolled environment of pre-hospital and emergency care, the lack of integrated understanding of the markedly different Emergency Medical Services (EMS) systems in the Asia-Pacific region, and varying outcomes reporting adds to the challenge to derive meaningful outcomes data from numerous sources and interpret them.

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