Trial reportBMC emergency medicine2010
Support and Assessment for Fall Emergency Referrals (SAFER 1) trial protocol. Computerised on-scene decision support for emergency ambulance staff to assess and plan care for older people who have fallen: evaluation of costs and benefits using a pragmatic cluster randomised trial.
Trial report in BMC emergency medicine, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 4 syntheses or guidelines pooled it, 32 citations in OpenAlex.
- Pooled it
- Multifactorial and multiple component interventions for preventing falls in older people living in the community.The Cochrane database of systematic reviews · 2018Pooled it
- Assessment of consent models as an ethical consideration in the conduct of prehospital ambulance randomised controlled clinical trials: a systematic review.BMC medical research methodology · 2017Pooled it
- Interventions for preventing falls in older people living in the community.The Cochrane database of systematic reviews · 2012Pooled it
- Trial
- Ten years of EMS Fall Calls in a Community: An Opportunity for Injury Prevention Strategies.Geriatric orthopaedic surgery & rehabilitation · 2018Article
- Referral pathways for patients with TIA avoiding hospital admission: a scoping review.BMJ open · 2017Article
- Rapid analgesia for prehospital hip disruption (RAPID): protocol for feasibility study of randomised controlled trial.Pilot and feasibility studies · 2017Article
- Lightweight physiologic sensor performance during pre-hospital care delivered by ambulance clinicians.Journal of clinical monitoring and computing · 2016Article
- Article
- Qualitative research within trials: developing a standard operating procedure for a clinical trials unit.Trials · 2013Article
- Evolving prehospital, emergency department, and "inpatient" management models for geriatric emergencies.Clinics in geriatric medicine · 2013Review
- Article
- Reductions in hospital admissions and mortality rates observed after integrating emergency care: a natural experiment.BMJ open · 2012Article
- High yield research opportunities in geriatric emergency medicine: prehospital care, delirium, adverse drug events, and falls.The journals of gerontology. Series A, Biological sciences and medical sciences · 2011Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
18 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMany emergency ambulance calls are for older people who have fallen. As half of them are left at home, a community-based response may often be more appropriate than hospital attendance. The SAFER 1 trial will assess the costs and benefits of a new healthcare technology--hand-held computers with computerised clinical decision support (CCDS) software--to help paramedics decide who needs hospital attendance, and who can be safely left at home with referral to community falls services. METHODS/
designPragmatic cluster randomised trial with a qualitative component. We shall allocate 72 paramedics ('clusters') at random between receiving the intervention and a control group delivering care as usual, of whom we expect 60 to complete the trial.Patients are eligible if they are aged 65 or older, live in the study area but not in residential care, and are attended by a study paramedic following an emergency call for a fall. Seven to 10 days after the index fall we shall offer patients the opportunity to opt out of further follow up. Continuing participants will receive questionnaires after one and 6 months, and we shall monitor their routine clinical data for 6 months. We shall interview 20 of these patients in depth. We shall conduct focus groups or semi-structured interviews with paramedics and other stakeholders.The primary outcome is the interval to the first subsequent reported fall (or death). We shall analyse this and other measures of outcome, process and cost by 'intention to treat'. We shall analyse qualitative data thematically. DISCUSSION: Since the SAFER 1 trial received funding in August 2006, implementation has come to terms with ambulance service reorganisation and a new national electronic patient record in England. In response to these hurdles the research team has adapted the research design, including aspects of the intervention, to meet the needs of the ambulance services.In conclusion this complex emergency care trial will provide rigorous evidence on the clinical and cost effectiveness of CCDS for paramedics in the care of older people who have fallen.
trial registrationISRCTN10538608.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.