Research in Emergency and Critical Care Settings: Debates, Obstacles and Solutions

El‐Menyar, Ayman; Asim, Mohammad; Latifi, Rifat; Al-Thani, Hassan

doi:10.1007/s11948-015-9730-5

Cited by 14 publications

(10 citation statements)

References 58 publications

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“…As the time frame to consent patients in the ED is usually shorter than for other specialties, 27 and the time taken for an explanation of research could delay the immediate clinical intervention, 28 the availability of translated material could help to improve EM study enrollment. Other potential solutions that may address the challenge of enrolling EM patients include conducting less complex, shorter intervention studies, 2 and either waiving or allowing deferred consent in EM clinical trials.…”

Section: Discussionmentioning

confidence: 99%

Factors Influencing Participation in Clinical Trials: Emergency Medicine vs. Other Specialties

Kurt

Kincaid

Mph

et al. 2017

WestJEM

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IntroductionThis study investigated factors that influence emergency medicine (EM) patients’ decisions to participate in clinical trials and whether the impact of these factors differs from those of other medical specialties.MethodsA survey was distributed in EM, family medicine (FM), infectious disease (ID), and obstetrics/gynecology (OB/GYN) outpatient waiting areas. Eligibility criteria included those who were 18 years of age or older, active patients on the day of the survey, and able to complete the survey without assistance. We used the Kruskal-Wallis test and ordinal logistic regression analyses to identify differences in participants’ responses.ResultsA total of 2,893 eligible subjects were approached, and we included 1,841 surveys in the final analysis. Statistically significant differences (p≤0.009) were found for eight of the ten motivating factors between EM and one or more of the other specialties. Regardless of a patient’s gender, race, and education, the relationship with their doctor was more motivating to patients seen in other specialties than to EM patients (FM [odds ratio {OR}:1.752, 95% confidence interval {CI}{1.285–2.389}], ID [OR:3.281, 95% CI{2.293–4.695}], and OB/GYN [OR:2.408, 95% CI{1.741–3.330}]). EM’s rankings of “how well the research was explained” and whether “the knowledge learned would benefit others” as their top two motivating factors were similar across other specialties. All nine barriers showed statistically significant differences (p≤0.008) between EM and one or more other specialties. Participants from all specialties indicated “risk of unknown side effects” as their strongest barrier. Regardless of the patients’ race, “time commitment” was considered to be more of a barrier to other specialties when compared to EM (FM [OR:1.613, 95% CI{1.218–2.136}], ID [OR:1.340, 95% CI{1.006–1.784}], or OB/GYN [OR:1.901, 95% CI{1.431–2.526}]). Among the six resources assessed that help patients decide whether to participate in a clinical trial, only one scored statistically significantly different for EM (p<0.001). EM patients ranked “having all material provided in my own language” as the most helpful resource.ConclusionThere are significant differences between EM patients and those of other specialties in the factors that influence their participation in clinical trials. Providing material in the patient’s own language, explaining the study well, and elucidating how their participation might benefit others in the future may help to improve enrollment in EM-based clinical trials.

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Section: Discussionmentioning

confidence: 99%

Factors Influencing Participation in Clinical Trials: Emergency Medicine vs. Other Specialties

Kurt

Kincaid

Mph

et al. 2017

WestJEM

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“…Therefore, it is crucial to identify the potential benefits and major barriers in emergency research to cater evidence-based care. [13]…”

Section: Clinical Research In Traumamentioning

confidence: 99%

Evolution of the Qatar trauma system: The journey from inception to verification

Al-Thani

El‐Menyar

Asim

et al. 2019

J Emerg Trauma Shock

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Traumatic injuries accounted for substantial burden of morbidity and mortality (M and M) worldwide. Despite better socioeconomic conditions and living standards, the incidence of trauma is rising in the Eastern Mediterranean Region (EMR). Road traffic injuries are the leading cause of the high fatality rate in young economically productive adults in our region. The provision of trauma care at high-volume, accredited trauma center by a team of dedicated full-time professional health-care providers has been shown to improve the quality of care and the outcomes for trauma victims. With persistent hard work and effective leadership, in Qatar, the Trauma Section has evolved into a well-reputed and internationally recognized Center of Excellence in Trauma Care, Hamad Level 1 Trauma Center. In 2014, Qatar Trauma System was accredited with Trauma Distinction Award by the Accreditation Canada International, for high-quality trauma care of severely injured patients; first in the Middle East. The Hamad Trauma Center is committed to the advancement of trauma care in different aspects right from the immediate prehospital care to the subsequent hospital-based care, involving diagnosis, treatment, support, rehabilitation, and community reintegration of the patients and injury prevention. Our trauma system has gradually embedded with a structured and matured research unit with dedicated clinicians and academic researchers. The trauma team embodies the 21st-century paradigm of translational research and injury prevention by going well beyond the bedside, out into the populations that need it most. The trauma system's future vision relies on the evidence-based health-care service and better outcomes; state-of-the-art infrastructure and multidimensional collaborations with health care and governmental services to minimize the burden of M and M caused by traumatic injury in the State of Qatar and to fulfill the population health enhancement strategy.

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“…20 There are formidable challenges to conducting research in the EM setting, including the fast-paced/ high-pressure environment, time constraints, and difficulties obtaining consent. 21 In research involving trauma patients, these challenges may be amplified and contribute to the paucity of studies in this area. Increasing and prioritizing funding, as well as addressing ethical issues, expanding and creating trauma research networks, and developing a standard template for trauma research are some suggestions that emerged from the NIH Roundtable on Emergency Trauma Research convened to enhance research in this field.…”

Section: Discussionmentioning

confidence: 99%

Quality and Publication of Emergency Medicine Trials Registered in ClinicalTrials.gov

Calvocoressi¹,

Reynolds²,

Johnson³

et al. 2020

WestJEM

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Introduction: Promoting emergency medicine (EM) clinical trials research remains a priority. To characterize the status of clinical EM research, this study assessed trial quality, funding source, and publication of EM clinical trials and compared EM and non-EM trials on these key metrics. We also examined the volume of EM trials and their subspecialty areas. Methods: We abstracted data from ClinicalTrials.gov (February 2000-September 2013) and used individual study National Clinical Trial numbers to identify published trials (January 2007-September 2016). We used descriptive statistics and chi-square tests to examine study characteristics by EM and non-EM status, and Kaplan-Meier curves and log-rank tests to compare time to publication of completed EM and non-EM studies. Results: We found 638 interventional EM trials and 59,512 non-EM interventional trials conducted in the United States between February 2000 and September 2013, registered on ClinicalTrials.gov. EM studies were significantly less likely than non-EM studies to be National Institutes of Health-funded or to evaluate a drug or biologic. However, EM studies had significantly larger sample sizes, and were significantly more likely to use randomization and blinding. Overall, 34.3% of EM and 26.0% of non-EM studies were published in peer-reviewed journals. By subspecialty, more EM trials concerned medical/surgical and psychiatric/neurological conditions than trauma. Conclusion: Although EM studies were less likely to have received federal or industry funding, and the EM portfolio consisted of only 638 trials over the 14-year study period, the quality of EM trials surpassed that of non-EM trials, based on indices such as randomization and blinding. This novel finding bodes well for the future of clinical EM research, as does the higher proportion of published EM than non-EM trials. Our study also revealed that trauma studies were under-represented among EM studies. Periodic assessment of EM trials with the metrics used here could provide an informative and valuable longitudinal view of progress in clinical EM research. [West J Emerg Med. 2020;21(2)295-303.] and trauma care research through additional federal funding; 2) assessing research needs, gaps, and opportunities; and 3) encouraging academic medical centers to provide research time and facilities. 4-5 Those recommendations prompted roundtable

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Research in Emergency and Critical Care Settings: Debates, Obstacles and Solutions

Cited by 14 publications

References 58 publications

Factors Influencing Participation in Clinical Trials: Emergency Medicine vs. Other Specialties

Factors Influencing Participation in Clinical Trials: Emergency Medicine vs. Other Specialties

Evolution of the Qatar trauma system: The journey from inception to verification

Quality and Publication of Emergency Medicine Trials Registered in ClinicalTrials.gov

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