Trauma care research and the war on uncertainty
Trauma care research and the war on uncertainty
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创伤护理研究和对不确定性的战争
DOI：
10.1136/bmj.331.7525.1094
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发表时间：
2005
期刊：
影响因子：
--
通讯作者：
P. Sandercock
中科院分区：
文献类型：
--
作者：
I. Roberts;H. Shakur;P. Edwards;D. Yates;P. Sandercock
改善创伤护理需要大型试验-而大型试验需要资金和合作
1 2全世界每天有30多万人严重受伤，其中约1万人死亡。道路交通事故和暴力是主要原因。据预测，2000年至2020年期间，全球道路死亡人数将增加65%，暴力死亡人数也在稳步增加，世纪是有记录以来暴力死亡人数最多的世纪。尽管采取了最好的预防措施，但提供有效的创伤护理仍然是医疗保健专业人员面临的主要挑战。通过使用临床审计来增加创伤服务中循证干预措施的实施，有相当大的潜力来改善创伤结局。3然而，对于许多创伤护理干预措施，风险和收益的平衡是不确定的，必须在实施前在随机试验中进行评估。
与疾病负担相比，创伤护理的临床试验缺乏，现有的试验规模较小，导致有效性的不确定性（见表）。
Improving trauma care demands large trials—and large trials need funding and collaboration
For people aged 5-45 years trauma is second only to HIV/AIDS as a cause of death.1 2 Every day world wide over 300 000 people are severely injured, about 10 000 of whom die. Road traffic crashes and violence are the leading causes. The global number of road deaths is forecast to rise by 65% between 2000 and 2020 and the number of violent deaths has increased steadily, with the 20th century being the most violent on record. Despite the best preventive efforts, providing effective trauma care will remain a major challenge for healthcare professionals. There is considerable potential to improve trauma outcomes by using clinical audit to increase the implementation of evidence based interventions in trauma services.3 However, for many trauma care interventions, the balance of risks and benefits is uncertain and they must be assessed in randomised trials before being implemented.
Compared with the disease burden there is a dearth of clinical trials in trauma care and the existing trials are small, contributing to uncertainty about effectiveness (see table).4 For example, few if any of the pharmacological treatments for brain and …