Use of CPR feedback devices in resuscitation training: A systematic review and meta-analysis of randomized controlled trials

Objectives: The use of cardiopulmonary resuscitation (CPR) feedback devices during training is increasing. This review evaluates whether incorporating CPR feedback devices in training improves patient survival, CPR quality in actual resuscitation, skill acquisition and retention after training. Meth...

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Main Authors: Yiqun Lin, Andrew Lockey, Aaron Donoghue, Robert Greif, Andrea Cortegiani, Barbara Farquharson, Fahad Javaid Siddiqui, Arna Banerjee, Tasuku Matsuyama, Adam Cheng
Format: Article
Language:English
Published: Elsevier 2025-05-01
Series:Resuscitation Plus
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666520425000761
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author Yiqun Lin
Andrew Lockey
Aaron Donoghue
Robert Greif
Andrea Cortegiani
Barbara Farquharson
Fahad Javaid Siddiqui
Arna Banerjee
Tasuku Matsuyama
Adam Cheng
author_facet Yiqun Lin
Andrew Lockey
Aaron Donoghue
Robert Greif
Andrea Cortegiani
Barbara Farquharson
Fahad Javaid Siddiqui
Arna Banerjee
Tasuku Matsuyama
Adam Cheng
author_sort Yiqun Lin
collection DOAJ
description Objectives: The use of cardiopulmonary resuscitation (CPR) feedback devices during training is increasing. This review evaluates whether incorporating CPR feedback devices in training improves patient survival, CPR quality in actual resuscitation, skill acquisition and retention after training. Methods: This systematic review was part of the continuous evidence evaluation process of the International Liaison Committee on Resuscitation (ILCOR). We searched MEDLINE, EMBASE, and SCOPUS databases from inception to September 30, 2024, including randomized controlled trials (RCTs) in all languages (with an English abstract) comparing CPR training with and without feedback devices. Outcome included patient survival, quality of clinical performance in resuscitation, and CPR skill acquisition and retention. Non-RCT studies, unpublished work without peer review or animal studies were excluded. Risk of bias was assessed using Cochrane tools, and certainty of evidence was graded using the Grading of Recommendations Assessment, development and Evaluation (GRADE) approach. Standardized mean difference (SMD) were calculated and pooled effects were analyzed using random-effects models. PROSPERO CRD42023488130. Results: We identified 20 RCTs with 4579 participants. Risks of bias ranged from low to critical (low: 8, moderate: 9, and critical: 3). No studies evaluated the patient survival, clinical performance in resuscitation or cost-effectiveness. Compared to no feedback, using CPR feedback devices during training significantly improved key quality metrics. Pooled effect sizes were 0.76 (95%CI 0.02 – 1.50) for mean compression depth (15 studies), 0.98 (95%CI: 0.10 – 1.87) for depth compliance (16 studies), 0.29 (95%CI: 0.10 – 0.48) for mean rate (17 studies), 0.44 (95%CI: 0.23 – 0.66) for rate compliance (9 studies), and 0.53 (95%CI: 0.31 – 0.75) for recoil compliance (10 studies) in favour of using feedback devices during training. Heterogeneity was large (I2 > 50%) in all analyses. Planned subgroup analyses revealed no statistically significant interaction between healthcare professionals and laypersons. Using the GRADE approach, the certainty of evidence was downgraded for certain outcomes due to critical risk of bias for 3 studies and inconsistency but upgraded for strong association. Conclusion: The use of CPR feedback devices during resuscitation training improves key quality metrics of CPR performance, with moderate to high certainty of evidence. However, further studies are needed to evaluate the impact on cost-effectiveness, clinical performance and patient outcomes.
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spelling doaj-art-c4c3db32e6304b00afeaaefcc24874b92025-08-20T03:53:53ZengElsevierResuscitation Plus2666-52042025-05-012310093910.1016/j.resplu.2025.100939Use of CPR feedback devices in resuscitation training: A systematic review and meta-analysis of randomized controlled trialsYiqun Lin0Andrew Lockey1Aaron Donoghue2Robert Greif3Andrea Cortegiani4Barbara Farquharson5Fahad Javaid Siddiqui6Arna Banerjee7Tasuku Matsuyama8Adam Cheng9KidSIM-ASPIRE Simulation Research Program, Alberta Children’s Hospital, University of Calgary, Calgary, Canada; Corresponding author at: KidSIM-ASPIRE Simulation Research Program, Alberta Children's Hospital, 28 Oki Dr NW, Calgary, Alberta, Canada T3B 6A8.Emergency Department, Calderdale & Huddersfield NHS Trust, Halifax, UK; School of Human and Health Sciences, University of Huddersfield, Huddersfield, UKPICU, Children’s Hospital of Philadelphia, Philadelphia, PA, USAFaculty of Medicine, University of Bern, Bern, Switzerland; Department of Surgical Science, University of Torino, Torino, ItalyDepartment of Precision Medicine in Medical, Surgical and Critical Care Area (Me.Pre.C.C.) University of Palermo, Palermo, Italy; Department of Anesthesia, Intensive Care and Emergency, Policlinico Paolo Giaccone Palermo ItalyNursing, Midwifery and Allied Health Professional’s Research Unit (NMAHP), Faculty of Health Sciences & Sport, University of Stirling, UKCochrane Singapore, Singapore Clinical Research Institute, SingaporeDepartment of Anesthesiology, Surgery and Medical Education, Vanderbilt University Medical Center, Nashville, TN, USADepartment of Emergency Medicine, Kyoto Prefectural University of Medicine, Kyoto, JapanDepartment of Pediatrics and Emergency Medicine, Cumming School of Medicine, University of Calgary, Canada; KidSIM-ASPIRE Simulation Research Program, Alberta Children’s Hospital, University of Calgary, CanadaObjectives: The use of cardiopulmonary resuscitation (CPR) feedback devices during training is increasing. This review evaluates whether incorporating CPR feedback devices in training improves patient survival, CPR quality in actual resuscitation, skill acquisition and retention after training. Methods: This systematic review was part of the continuous evidence evaluation process of the International Liaison Committee on Resuscitation (ILCOR). We searched MEDLINE, EMBASE, and SCOPUS databases from inception to September 30, 2024, including randomized controlled trials (RCTs) in all languages (with an English abstract) comparing CPR training with and without feedback devices. Outcome included patient survival, quality of clinical performance in resuscitation, and CPR skill acquisition and retention. Non-RCT studies, unpublished work without peer review or animal studies were excluded. Risk of bias was assessed using Cochrane tools, and certainty of evidence was graded using the Grading of Recommendations Assessment, development and Evaluation (GRADE) approach. Standardized mean difference (SMD) were calculated and pooled effects were analyzed using random-effects models. PROSPERO CRD42023488130. Results: We identified 20 RCTs with 4579 participants. Risks of bias ranged from low to critical (low: 8, moderate: 9, and critical: 3). No studies evaluated the patient survival, clinical performance in resuscitation or cost-effectiveness. Compared to no feedback, using CPR feedback devices during training significantly improved key quality metrics. Pooled effect sizes were 0.76 (95%CI 0.02 – 1.50) for mean compression depth (15 studies), 0.98 (95%CI: 0.10 – 1.87) for depth compliance (16 studies), 0.29 (95%CI: 0.10 – 0.48) for mean rate (17 studies), 0.44 (95%CI: 0.23 – 0.66) for rate compliance (9 studies), and 0.53 (95%CI: 0.31 – 0.75) for recoil compliance (10 studies) in favour of using feedback devices during training. Heterogeneity was large (I2 > 50%) in all analyses. Planned subgroup analyses revealed no statistically significant interaction between healthcare professionals and laypersons. Using the GRADE approach, the certainty of evidence was downgraded for certain outcomes due to critical risk of bias for 3 studies and inconsistency but upgraded for strong association. Conclusion: The use of CPR feedback devices during resuscitation training improves key quality metrics of CPR performance, with moderate to high certainty of evidence. However, further studies are needed to evaluate the impact on cost-effectiveness, clinical performance and patient outcomes.http://www.sciencedirect.com/science/article/pii/S2666520425000761ResuscitationCPR FeedbackTrainingBasic Life SupportMedical Education
spellingShingle Yiqun Lin
Andrew Lockey
Aaron Donoghue
Robert Greif
Andrea Cortegiani
Barbara Farquharson
Fahad Javaid Siddiqui
Arna Banerjee
Tasuku Matsuyama
Adam Cheng
Use of CPR feedback devices in resuscitation training: A systematic review and meta-analysis of randomized controlled trials
Resuscitation Plus
Resuscitation
CPR Feedback
Training
Basic Life Support
Medical Education
title Use of CPR feedback devices in resuscitation training: A systematic review and meta-analysis of randomized controlled trials
title_full Use of CPR feedback devices in resuscitation training: A systematic review and meta-analysis of randomized controlled trials
title_fullStr Use of CPR feedback devices in resuscitation training: A systematic review and meta-analysis of randomized controlled trials
title_full_unstemmed Use of CPR feedback devices in resuscitation training: A systematic review and meta-analysis of randomized controlled trials
title_short Use of CPR feedback devices in resuscitation training: A systematic review and meta-analysis of randomized controlled trials
title_sort use of cpr feedback devices in resuscitation training a systematic review and meta analysis of randomized controlled trials
topic Resuscitation
CPR Feedback
Training
Basic Life Support
Medical Education
url http://www.sciencedirect.com/science/article/pii/S2666520425000761
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