About CoSTR

Continuous Evidence Evaluation (CEE) and Consensus on Science and Treatment Recommendations (CoSTRs)

ILCOR has implemented a continuous evidence evaluation process to ensure timely delivery and dissemination of the highest-quality resuscitation science evidence evaluation and consensus on treatment recommendations. It is essential that all members of the resuscitation community—policy makers, organizations, healthcare professionals, patients, and the public—have easy and timely access to the most current evidence.


The 2015 CoSTR publication describes our transition from a 5-year cycle of evidence review to a near-continuous evidence evaluation process. CoSTR statements will be published continuously on the ilcor.org website and summarized in an annual CoSTR summary publication in major journals. 


To facilitate the continuous evidence evaluation process, ILCOR uses the services of contracted expert systematic reviewers to review existing evidence related to a specific question, to perform meta-analyses of the data, and summarize the science. The relevant task forces work with the expert systematic reviewers by providing topic content experts and review of GRADE evidence profile to produce a final Consensus on Science with Treatment Recommendations. The GRADE Evidence to Decision framework is being used by the task forces to assist with development of treatment recommendations. In some cases, several similar questions related to resuscitation and first aid may be combined into a ‘mega’ review. ILCOR uses contracted organizations, or Knowledge Synthesis Units, who are international leaders in evidence evaluation and GRADE methodology to conduct these complex reviews. 


ILCOR recommends that you view this short 3-minute video to gain additional information about the ILCOR CoSTRs and the methodology by which they are reached.