Author Contributions: Dr Stiell had full access
to all of the data in the study and takes responsibility for the integrity
of the data and the accuracy of the data analysis.
Study concept and design: Stiell, Schull, Brison,
Cass, Eisenhauer, Dreyer, Reardon, Greenberg, Lesiuk, MacPhail, Wells.
Acquisition of data: Stiell, Clement, Rowe,
Schull, Brison, Cass, Eisenhauer, McKnight, Bandiera, Holroyd, Lee, Dreyer,
Analysis and interpretation of data: Stiell,
Worthington, Lesiuk, Wells.
Drafting of the manuscript: Stiell, Clement,
Rowe, Schull, Eisenhauer, Reardon.
Critical revision of the manuscript for important
intellectual content: Rowe, Brison, Cass, Eisenhauer, McKnight, Bandiera,
Holroyd, Lee, Dreyer, Worthington, Reardon, Greenberg, Lesiuk, MacPhail, Wells.
Statistical analysis: Stiell, Wells.
Obtained funding: Stiell, Clement.
Administrative, technical, or material support:
Clement, Schull, Brison, Cass, Eisenhauer, Bandiera, Lee, Dreyer, Worthington,
Reardon, Lesiuk, MacPhail.
Study supervision: Stiell, Clement, Rowe, Brison,
Eisenhauer, McKnight, Holroyd, Greenberg.
Financial Disclosures: None reported.
Funding/Support: This study was funded by peer-reviewed
grants MT-13700 from the Canadian Institutes of Health Research and 11996N
from the Ontario Ministry of Health Emergency Health Services Committee. Dr
Stiell holds a Distinguished Investigator Award, Dr Schull holds a New Investigator
Award, and Dr Rowe holds a Canada Research Chair, all from the Canadian Institutes
of Health Research.
Role of the Sponsor: The Canadian Institutes
of Health Research had no role in the design and conduct of the study; the
collection, management, analysis, and interpretation of data; or the preparation,
review, or approval of the manuscript.
Participating Hospitals:Alberta: University of Alberta Hospital, Edmonton; British Columbia: Royal Columbian Hospital, New Westminster, and Vancouver
General Hospital, Vancouver; and Ontario: Kingston
General Hospital, Kingston; Ottawa Hospital–Civic Campus and Ottawa
Hospital–General Campus, Ottawa; Sunnybrook and Women's College Health
Sciences Centre, Toronto; London Health Sciences Centre–Victoria Campus,
London; and St Michael’s Hospital, Toronto.
Acknowledgment: We thank the following for
their much appreciated efforts: study nurses Erica Battram, RN, Kim Bradbury,
RN, Pamela Sheehan, RN, and Taryn MacKenzie, RN, from The Ottawa Hospitals;
Kathy Bowes, RN, from Kingston General Hospital; Karen Code, RN, and Ann Zerdin,
RN, from Sunnybrook and Women’s College; Virginia Blak-Genoway, RN,
from St Michael’s Hospital; Evelyn Gilkinson, RN, and Sharon Mason from
London Health Sciences Centre; Percy MacKerricher, RN, from the Royal Columbian
Hospital; Jan Buchanan, RN, from Vancouver General Hospital; Jackie Miller,
RN, Lloyd Tapper, RN, and Terry Shewchuk, RN, from University of Alberta Hospital;
data management MyLinh Tran and Emily Moen; manuscript preparation Irene Harris,
all of whom received salary support; all the nurses and clerks at the study
sites who assisted with case identification and data collection. We are particularly
grateful to the many staff physicians and residents who patiently completed
thousands of data collection forms and without whose voluntary assistance
this study would not have been possible.