RECOVER evidence and knowledge gap analysis on veterinary CPR. Part 1: Evidence analysis and consensus process: collaborative path toward small animal CPR guidelines


  • Manuel Boller Dr. med. vet., MTR, DACVECC,

    Corresponding author
    • Department of Emergency Medicine, School of Medicine, Center for Resuscitation Science, and the Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA
    Search for more papers by this author
  • Daniel J. Fletcher PhD, DVM, DACVECC

    1. College of Veterinary Medicine, Department of Clinical Sciences, Cornell University, Ithaca, NY
    Search for more papers by this author

  • Drs. M. Boller and D. J. Fletcher are equal first co-authors.

  • The authors declare no conflicts of interests.

Address correspondence and reprint requests to

Dr. Manuel Boller, Center for Resuscitation Science, School of Medicine, University of Pennsylvania, 125 S 31st St - Suite 1200, Philadelphia, PA 19104, USA.




To describe the methodology used by the Reassessment Campaign on Veterinary Resuscitation (RECOVER) to evaluate the scientific evidence relevant to small animal CPR and to compose consensus-based clinical CPR guidelines for dogs and cats.


This report is part of a series of 7 articles on the RECOVER evidence and knowledge gap analysis and consensus-based small animal CPR guidelines. It describes the organizational structure of RECOVER, the evaluation process employed, consisting of standardized literature searches, the analysis of relevant articles according to study design, species and predefined quality markers, and the drafting of clinical CPR guidelines based on these data. Therefore, this article serves as the methodology section for the subsequent 6 RECOVER articles.


Academia, referral practice.


RECOVER is a collaborative initiative that systematically evaluated the evidence on 74 topics relevant to small animal CPR and generated 101 clinical CPR guidelines from this analysis. All primary contributors were veterinary specialists, approximately evenly split between academic institutions and private referral practices. The evidence evaluation and guideline drafting processes were conducted according to a predefined sequence of steps designed to reduce bias and increase the repeatability of the findings, including multiple levels of review, culminating in a consensus process. Many knowledge gaps were identified that will allow prioritization of research efforts in veterinary CPR.


Collaborative systematic evidence review is organizationally challenging but feasible and effective in veterinary medicine. More experience is needed to refine the process.