{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T10:10:28Z","timestamp":1783937428034,"version":"3.55.0"},"reference-count":16,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"vor","delay-in-days":193,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Emergency Medicine International"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>\n                    Out\u2010of\u2010hospital cardiac arrest (OHCA) is a critical public health issue, with survival rates varying widely due to multiple well\u2010established factors, including emergency medical service (EMS) system structure, bystander response, initial cardiac rhythm, and patient\u2010level characteristics. This study evaluates the Utstein\u2010Based Return of Spontaneous Circulation (UB\u2010ROSC) score\u2019s performance in predicting sustained Return of Spontaneous Circulation (ROSC &gt; 2\u2009h) in a midsized Asian city where EMS delivery is standardized and geographic variation in access is minimal. A total of 209 OHCA cases from Chiayi City in 2024 were analyzed, using Utstein\u2010aligned data to compute UB\u2010ROSC scores. Predictive performance was assessed via receiver operating characteristic (ROC) curves, calibration intercept and slope, the Hosmer\u2013Lemeshow goodness\u2010of\u2010fit test, and bootstrap internal validation, focusing on sustained return of spontaneous circulation (ROSC) (&gt; 2\u2009h). After excluding pediatric and traumatic cases, 209 cases were analyzed. The cohort was 60.3% male, with 47.8% witnessed arrests and 67.0% receiving bystander CPR. The UB\u2010ROSC score demonstrated fair discrimination, with an area under the ROC curve (AUC) of 0.78 (95% confidence interval [CI]: 0.70\u20130.85), stable on bootstrap and cross\u2010validation. The calibration slope was 0.90 (95% CI: 0.62\u20131.18) but the calibration intercept was +0.71 (95% CI: 0.36\u20131.05), and the Hosmer\u2013Lemeshow test was significant (\n                    <jats:italic>\u03c7<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u200928.6,\n                    <jats:italic>p<\/jats:italic>\n                    &lt; 0.001), indicating systematic underprediction of observed survival. Risk stratification yielded a low\u2010risk group (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009109) with a 15.6% ROSC rate, a medium\u2010risk group (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200994) with a 48.9% rate, and a high\u2010risk group (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20096) with an 83.3% rate. The Chiayi cohort showed a slightly higher observed ROSC rate in the low\u2010risk group, whereas the medium\u2010 and high\u2010risk groups fell within the predicted ranges although estimates in the high\u2010risk group were imprecise because of the small sample size. Local recalibration may be needed before applying absolute probability estimates in clinical settings.\n                  <\/jats:p>","DOI":"10.1155\/emmi\/5871234","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T09:25:07Z","timestamp":1783934707000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Validation of the UB\u2010ROSC Score for Predicting OHCA Survival in Chiayi City, Taiwan"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9194-7245","authenticated-orcid":false,"given":"Wei Ta","family":"Chang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8559-4041","authenticated-orcid":false,"given":"Chung Chyi","family":"Chou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4029-714X","authenticated-orcid":false,"given":"Chia-Chou","family":"Tsai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,13]]},"reference":[{"key":"e_1_2_13_1_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-020-2773-2"},{"key":"e_1_2_13_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2019.12.042"},{"key":"e_1_2_13_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000916"},{"key":"e_1_2_13_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jfma.2021.01.015"},{"key":"e_1_2_13_5_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-023-02779-w"},{"key":"e_1_2_13_6_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18073636"},{"key":"e_1_2_13_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2020.01.032"},{"key":"e_1_2_13_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehr107"},{"key":"e_1_2_13_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv556"},{"key":"e_1_2_13_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12872-020-01571-5"},{"key":"e_1_2_13_11_2","doi-asserted-by":"crossref","DOI":"10.1186\/s13054-016-1226-4","article-title":"Applicability of Termination of Resuscitation Rules to out-of-hospital Cardiac Arrests in Japan","volume":"20","author":"Kashiura M.","year":"2016","journal-title":"Critical Care"},{"key":"e_1_2_13_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2015.07.026"},{"key":"e_1_2_13_13_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0180935"},{"key":"e_1_2_13_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2025.03.048"},{"key":"e_1_2_13_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.124.037088"},{"key":"e_1_2_13_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2024.110113"}],"container-title":["Emergency Medicine International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/emmi\/5871234","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/emmi\/5871234","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/emmi\/5871234","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T09:25:08Z","timestamp":1783934708000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/emmi\/5871234"}},"subtitle":[],"editor":[{"given":"Shashank","family":"Kaushik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":16,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/emmi\/5871234"],"URL":"https:\/\/doi.org\/10.1155\/emmi\/5871234","archive":["Portico"],"relation":{},"ISSN":["2090-2840","2090-2859"],"issn-type":[{"value":"2090-2840","type":"print"},{"value":"2090-2859","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-08-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"5871234"}}