Population-level impact of universal early AED implementation on out-of-hospital cardiac arrest outcomes: a machine learning analysis using synthetic patient data of 45-year projection study from Japan

Kubo, A; Tamura, S; Hiraide, A; Morioka, D; Murakami, R; Fukui, K; Inoue, S

doi:10.1016/j.resuscitation.2025.110904

Cardiac arrest & resuscitation

Population-level impact of universal early AED implementation on out-of-hospital cardiac arrest outcomes: a machine learning analysis using synthetic patient data of 45-year projection study from Japan

ResuscitationPublished 19 Nov 2025Modelling projection study using machine learning-generated synthetic registry data

Main finding · Favorable neurological outcomeResultRelative risk 2.16 95% CI 2.07–2.25

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Authors' conclusion

Machine learning-based modeling projects that universal bystander AED application in Japan over a period of four and a half decades could prevent approximately 235,000 deaths and result in 160,000 more survivors with good neurological recovery after OHCA.

Study context

Population: OHCA in Japan (synthetic registry-based dataset), projected through 2075synthetic dataset
Participants: 966,493 participants

Exposure: Universal early AED application vs current patterns
Outcome: One-month survival and favorable neurological outcome (CPC 1 or 2)
Follow-up: One month

Methodological detailssynthetic data from 2022 All-Japan Utstein Registry, Classification and Regression Trees, 45-year projection (2030-2075), modified Poisson regression

Synthetic data from 2022 All-Japan Utstein Registry
Classification and Regression Trees
45-year projection (2030-2075)
Modified Poisson regression

Main finding

Favorable neurological outcome · peak effectiveness 2055-2060

Relative risk

2.16

95% CI 2.07–2.25

Universal early AED vs Current patterns

RR 2.16 (95% CI 2.07–2.25)

As reported in the abstract

Observational data: associations, not effects.

Further findings

Deaths prevented over 45-year projection (2030-2075)

Deaths prevented (approximately): 235,000 (95% CI, 210,500-261,500)

Additional survivors with good neurological recovery over 45-year projection · 2030-2075

Additional survivors with good neurological recovery: 160,000 (95% CI, 142,000-181,000)

NNT (witnessed OHCA receiving bystander AED within 5 min) for one additional favorable neurological outcome

NNT: 19-29 (median 24)

Original publication

Population-level impact of universal early AED implementation on out-of-hospital cardiac arrest outcomes: a machine learning analysis using synthetic patient data of 45-year projection study from Japan. Resuscitation. Published 19 November 2025. doi:10.1016/j.resuscitation.2025.110904

Read the original article ↗

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