Systematic Review of Published Evidence Regarding Trauma System Effectiveness

Mann, N. Clay; Mullins, Richard J.; MacKenzie, Ellen J.; Jurkovich, Gregory J.; Mock, Charles

doi:10.1097/00005373-199909001-00007

Cited by 271 publications

(144 citation statements)

References 58 publications

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“…1,2 Rising awareness among policy-makers of the burden of injury 3 has led to an increased need for easily quantifiable metrics to improve the allocation of resources for the treatment of injuries. [4][5][6][7][8][9][10][11] The intervals involved in the treatment of femur fractures -injury to admission, admission to surgery and surgery to discharge -are easily measurable and may be useful in evaluating the efficiency with which a trauma system treats an injured patient.…”

Section: Introductionmentioning

confidence: 99%

Time intervals in the treatment of fractured femurs as indicators of the quality of trauma systems

Matityahu

Elliott

Marmor

et al. 2013

Bull. World Health Organ.

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Section: Introductionmentioning

confidence: 99%

Time intervals in the treatment of fractured femurs as indicators of the quality of trauma systems

Matityahu

Elliott

Marmor

et al. 2013

Bull. World Health Organ.

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“…This concept rapidly evolved into the development of formal, integrated trauma systems. Trauma centers and trauma systems in the United States have had a remarkable impact on improving outcomes of injured patients, 2,[5][6][7][8][9][10][11][12][13][14][15][16][17][18] reducing mortality by up to 15% in mature systems.…”

mentioning

confidence: 99%

Trauma System Development in a Theater of War: Experiences From Operation Iraqi Freedom and Operation Enduring Freedom

Eastridge

Jenkins

Flaherty

et al. 2006

The Journal of Trauma: Injury, Infection, and Critical Care

247

180

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“…Public expectation and a more careful review of the available evidence would argue for the application of the interventions that have been proven to be effective and discontinuation of those proven to be harmful or wasteful. Unfortunately, even those interventions with proven efficacy, such as care of nontraumatic cardiac arrest [1][2][3][4][5] and use of formal trauma systems for severe trauma, [6][7][8][9][10] are not uniformly applied. In addition, interventions in which the predominance of evidence demonstrates a lack of effectiveness and potential for harm are still being applied in some systems.…”

Section: The Importance Of Evidence-based Prehospital Patient Care Prmentioning

confidence: 99%

The Development of Evidence-based Prehospital Guidelines Using a GRADE-based Methodology

Brown¹,

Macias²,

Dayan³

et al. 2013

Prehospital Emergency Care

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Background. The burgeoning literature in prehospital care creates an opportunity to improve care through evidencebased guidelines (EBGs). Previously, an established process for the creation of such guidelines and adoption and implementation at the local level was lacking. This has led to great variability in the content of prehospital protocols in different jurisdictions across the globe. Recently the Federal Interagency Committee on Emergency Medical Services (FICEMS) and the National EMS Advisory Council (NEMSAC) approved a National Prehospital Evidence-based Guideline Model Process for the development, implementation, and evaluation of EBGs. The Model Process recommends the use of established guideline development tools such as Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). Objective. To describe the process of development of three prehospital EBGs using the National Prehospital EBG Model Process (EBG Model Process) and the GRADE EBG development tool. Methods. We conducted three unique iterations of the EBG Model Process utilizing the GRADE EBG development tool. The process involved 6 distinct and essential steps, including 1) assembling the expert panel and providing GRADE training; 2) defining the evidence-based guideline (EBG) content area and establishing the specific clinical questions to address in patient, intervention, comparison, and outcome (PICO) format; 3) prioritizing outcomes to facilitate systematic literature searches; 4) creating GRADE tables, or evidence profiles, for each PICO question; 5) vetting and endorsing GRADE evidence tables and drafting recommendations; and 6) synthesizing recommendations into an EMS protocol and visual algorithm. Feedback and suggestions for improvement were solicited from participants and relevant stakeholders in the process. Results. We successfully used the process to create three separate prehospital evidence-based guidelines, formatted into decision tree algorithms with levels of evidence and graded recommendations assigned to each decision point. However, the process revealed itself to be resource intensive, and most of the suggestions for improvement would require even more resource utilization. Conclusions. The National Prehospital EBG Model Process can be used to create credible, transparent, and usable

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Systematic Review of Published Evidence Regarding Trauma System Effectiveness

Cited by 271 publications

References 58 publications

Time intervals in the treatment of fractured femurs as indicators of the quality of trauma systems

Time intervals in the treatment of fractured femurs as indicators of the quality of trauma systems

Trauma System Development in a Theater of War: Experiences From Operation Iraqi Freedom and Operation Enduring Freedom

The Development of Evidence-based Prehospital Guidelines Using a GRADE-based Methodology

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