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Table 1 Summary of findings in the previous reviews on effectiveness of advanced vs. basic life support.

From: Is advanced life support better than basic life support in prehospital care? A systematic review


Author(s) of review, year, country

description of a review

contents of the review

assessment of the review



Liberman et al. 2000, Canada

non-systematic review, traumas only

15 studies from years 1983-1997; classification according to quality:

1. medium quality 5 studies favouring ALS, 1 study favouring BLS.

2.high quality: 1 favouring ALS, 1 study favouring BLS

3. very high quality: 1 favouring ALS, 6 favouring BLS

In general the quality of studies was poor, many studies quite old, the follow-up periods starting even from 1930's.

7 studies favourintg ALS,

8 studies favouring BLS.

Studies of higher quality favouring BLS.


Sethi et al. 2000


A systematic Cochrane-review


Only one study included

No difference between ALS and BLS


Nicholl et al. 2003,


A systematic review on the effectiveness of helicopter services

36 original studies

HEMS better than ground transportation, mortality OR = 0,86, not statistically significant.



Koskinen 2005,


thesis for master's degree in health economics, contains a non-systematic review

36 original studies

In general the quality of studies was poor

cost-effectiveness of a helicopter service was assessed to be 5750 €/life year gained (confidence interval 2000 - 24500€)


Isenberg and Bissel, 2005, Canada

A non-systematic review, four parts:

1. trauma

2. cardiac arrest

3. cardiac infarct

4. distubances of consciousness

20 original articles, 2 meta-analyses from years 1984-2004

1. Trauma: 14 studies, 8 favouring ALS, 6 BLS. All new studies favouring BLS

2. cardiac arrest: early resuscitation and defibrillation associated with better survival, no special effect of ALS detected.

3. Cardiac infarct: 1 study, no difference between ALS and BLS.

4. Disturbances of consciousness, 1 study, no difference between ALS and BLS.

In general results favouring BLS.

Review for paramedic-ALS only, physician-ALS excluded.


Thomas 2004, Thomas 2007

Qualitative review, renovation by a new version


No conclusion


Liberman 2007

Opinion-based article about trauma treatment, grounded by a non-systematic review


In general favouring BLS.