Beyond Utstein: implementation of a multisource uniform data base for prehospital cardiac arrest research

This article is an overview of the issues affecting the use of a multisource uniform data base for prehospital cardiac arrest research. The goals of data base standardization include improved communication between emergency medical services (EMS) systems and between EMS physicians and the lay public; improved quantification of EMS system performance and documentation of benefit; in-depth analysis of factors that contribute to outcome; and development of EMS system models that will enhance system planning. Challenges to developing a multisource research data base include establishing a concensus approach to data base development; enlisting EMS system cooperation; verifying the accuracy of the data collected; coordinating data storage and analysis; and obtaining fiscal support for such a project. One illustrative approach to initiating multisource data base research is outlined. The iterative nature of data base development, use, expansion, and refinement is emphasized. Future reports addressing the methodology of multisource data base development and application in EMS systems should build on these concepts.