RT Journal
A1 Stewart JA
T1 IT is time to get more accurate times to defibrillation
JF Archives of Internal Medicine
JO Archives of Internal Medicine
YR 2009
FD December 14
VO 169
IS 22
SP 2162
OP 2166
DO 10.1001/archinternmed.2009.451
UL http://dx.doi.org/10.1001/archinternmed.2009.451
AB 
Though the authors' attention to this problem is welcome, using the reported data to identify and emulate hospitals achieving “best practices” is likely to be a waste of time and effort. The problem is that the study was based on the time-interval data from the National Registry of Cardiopulmonary Resuscitation (NRCPR). The NRCPR's time-interval data come from handwritten code records and are rounded to the nearest minute, resulting in clearly invalid aggregate statistics: median times to first defibrillation of 0 minutes2 or 1 minute1 and first quartiles of 0 minutes.1- 2 These figures are clearly impossible, representing not only inaccuracy but gross underestimation of the problem of delayed defibrillation. Though the analysis of survival by quartiles indicates that the NRCPR data are not completely random, I believe that more accurate data are both desirable and achievable.