{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T01:51:36Z","timestamp":1791165096991,"version":"4.1.0"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Syst"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Training in high-quality chest compressions (CCs) is essential for effective resuscitation; however, it remains unclear how accurately real-time feedback systems, such as Laerdal Medical\u2019s (Stavanger, Norway) Quality CardioPulmonary Resuscitation (QCPR) scoring system, reflect guideline-compliant CC quality. We aimed to investigate how CC depth, rate, and spring resistance affect QCPR scores. We conducted an experimental study using a Resusci Anne QCPR manikin (Laerdal Medical, Stavanger, Norway) equipped with interchangeable 30-, 50-, and 60-kg chest springs and a Corpuls mechanical CC device (GS Elektromedizinische Ger\u00e4te G. Stemple GmbH, Kaufering, Germany). For each spring resistance, continuous CCs were delivered in two-minute intervals at predefined combinations of CC depth (2.0\u20136.0 cm) and rate (80\u2013120 compressions per minute). CC quality was quantified using the QCPR score (0%\u2013100%). Across all spring resistances, QCPR scores rose modestly at 3.0\u20133.5 cm and increased further at 4.0\u20134.5 cm, where the greatest score variation across preset CC rates and spring resistances was observed. At \u2265\u20095.0 cm, QCPR scores were consistently high (57%\u2013100%). Overall, CC depth was the primary determinant of the QCPR score, with the highest scores observed at \u2265\u20095.0 cm. Additionally, we observed QCPR score differences of up to 18% for identical preset CC depth and rate settings with different springs. High QCPR scores were often achieved outside guideline ranges, emphasizing the need to interpret QCPR scores alongside absolute CC parameters and use guideline-compliant metrics as the standard for training and research.<\/jats:p>","DOI":"10.1007\/s10916-026-02469-z","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T01:20:26Z","timestamp":1791163226000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of Chest Compression Depth, Rate, and Spring Resistance with \u201cQuality CardioPulmonary Resuscitation\u201d (QCPR) Scores in a Manikin Model"],"prefix":"10.1007","volume":"50","author":[{"given":"\u0160pela","family":"Metli\u010dar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kasper G","family":"Lauridsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregor","family":"\u0160tiglic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nino","family":"Fija\u010dko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"key":"2469_CR1","doi-asserted-by":"publisher","first-page":"S2","DOI":"10.1161\/CIR.0000000000001361","volume":"152","author":"KM Berg","year":"2025","unstructured":"Berg KM, Bray JE, Dj\u00e4rv T, Drennan IR, Greif R, Liley HG, et al. Executive Summary: 2025 International Liaison Committee on Resuscitation Consensus on Science With Treatment Recommendations. Circulation 2025;152:S2\u201322. https:\/\/doi.org\/10.1161\/CIR.0000000000001361.","journal-title":"Circulation"},{"key":"2469_CR2","doi-asserted-by":"publisher","unstructured":"Greif R, Abelairas-G\u00f3mez C, B\u00f6ttiger BW. European Resuscitation Council Guidelines 2025: Executive Summary. Resuscitation 2025;215. https:\/\/doi.org\/10.1016\/j.resuscitation.2025.110770.","DOI":"10.1016\/j.resuscitation.2025.110770"},{"key":"2469_CR3","doi-asserted-by":"publisher","unstructured":"Nabecker S, Raad T, Abelairas-G\u00f3mez C. European Resuscitation Council Guidelines 2025: Education for Resuscitation. Resuscitation 2025;215. https:\/\/doi.org\/10.1016\/j.resuscitation.2025.110739.","DOI":"10.1016\/j.resuscitation.2025.110739"},{"key":"2469_CR4","doi-asserted-by":"publisher","first-page":"e010491","DOI":"10.1161\/CIRCOUTCOMES.123.010491","volume":"16","author":"BK Nallamothu","year":"2023","unstructured":"Nallamothu BK, Greif R, Anderson T, Atiq H, Couto TB, Considine J, et al. Ten Steps Toward Improving In-Hospital Cardiac Arrest Quality of Care and Outcomes. Circ Cardiovasc Qual Outcomes 2023;16:e010491. https:\/\/doi.org\/10.1161\/CIRCOUTCOMES.123.010491.","journal-title":"Circ Cardiovasc Qual Outcomes"},{"key":"2469_CR5","unstructured":"Laerdal Medical. CPR scoring explained 2015."},{"key":"2469_CR6","doi-asserted-by":"publisher","first-page":"e0169591","DOI":"10.1371\/journal.pone.0169591","volume":"12","author":"A Cortegiani","year":"2017","unstructured":"Cortegiani A, Russotto V, Montalto F, Iozzo P, Meschis R, Pugliesi M, et al. Use of a Real-Time Training Software (Laerdal QCPR\u00ae) Compared to Instructor-Based Feedback for High-Quality Chest Compressions Acquisition in Secondary School Students: A Randomized Trial. PLOS ONE 2017;12:e0169591. https:\/\/doi.org\/10.1371\/journal.pone.0169591.","journal-title":"PLOS ONE"},{"key":"2469_CR7","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1016\/j.afjem.2022.02.001","volume":"12","author":"MJ Labuschagne","year":"2022","unstructured":"Labuschagne MJ, Arbee A, de Klerk C, de Vries E, de Waal T, Jhetam T, et al. A comparison of the effectiveness of QCPR and conventional CPR training in final-year medical students at a South African university. Afr J Emerg Med 2022;12:106\u201311. https:\/\/doi.org\/10.1016\/j.afjem.2022.02.001.","journal-title":"Afr J Emerg Med"},{"key":"2469_CR8","doi-asserted-by":"publisher","first-page":"e222","DOI":"10.1017\/dmp.2025.10164","volume":"19","author":"W-H Huang","year":"2025","unstructured":"Huang W-H. CPR Skill Achievement in Police First Responders: A Cross-Sectional Study Using QCPR and Kirkpatrick\u2019s Model. Disaster Med Public Health Prep 2025;19:e222. https:\/\/doi.org\/10.1017\/dmp.2025.10164.","journal-title":"Disaster Med Public Health Prep"},{"key":"2469_CR9","doi-asserted-by":"publisher","first-page":"101352","DOI":"10.1016\/j.resplu.2026.101352","volume":"29","author":"O Barbe","year":"2026","unstructured":"Barbe O, Hervieu L, Lefran\u00e7ois E, S\u00e9n\u00e9meaud C, Michel F, Macrez R, et al. Effect of in situ coaching on cardiopulmonary resuscitation quality: a multicenter randomized simulation study. Resusc Plus 2026;29:101352. https:\/\/doi.org\/10.1016\/j.resplu.2026.101352.","journal-title":"Resusc Plus"},{"key":"2469_CR10","doi-asserted-by":"publisher","first-page":"e59720","DOI":"10.2196\/59720","volume":"10","author":"A Nicolau","year":"2024","unstructured":"Nicolau A, Jorge I, Vieira-Marques P, Sa-Couto C. 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