Evidence map›Paper›PMID 25968303›Full record

Trial reportTrials2015

What is the effect of a formalised trauma tertiary survey procedure on missed injury rates in multi-trauma patients? Study protocol for a randomised controlled trial.

Gerben B Keijzers, Chris Del Mar, Leo M G Geeraedts, Joshua Byrnes, Elaine M Beller

Open access · goldAbstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Trials, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.9field-weighted citation impact, top 23% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 5 citations in OpenAlex.

  1. Maxillofacial and concomitant serious injuries: An eight-year single center experience.Chinese journal of traumatology = Zhonghua chuang shang za zhi · 2017
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 4 institutions in 2 countries.

Gerben B KeijzersEmergency Physician, Staff Specialist, Emergency Department, Gold Coast Health Service District, Emergency Department, Gold Coast University Hospital, 1 Hospital Boulevard, Southport, 4215, QLD, Australia. Gerben.Keijzers@health.qld.gov.au.
Chris Del MarProfessor of Public Health, School of Medicine, Bond University, University Drive, Robina, Gold Coast, 4226, QLD, Australia. cdelmar@bond.edu.au.
Leo M G GeeraedtsTrauma Surgeon, Department of Surgery, VU University Medical Centre, PO Box 7057, 1007, MB, Amsterdam, The Netherlands. l.geeraedts@vumc.nl.
Joshua ByrnesGriffith Health Institute, Griffith University, Gold Coast Campus, Gold Coast, 4222, QLD, Australia. j.byrnes@griffith.edu.au.
Elaine M BellerStatistician, Associate Professor, Centre for Research in Evidence-based practice, Bond University, University Drive, Robina, Gold Coast, 4226, QLD, Australia. ebeller@bond.edu.au.
Bond University · AUAmsterdam UMC Location VUmc · NLGold Coast Health · AUGriffith University · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMissed injury is commonly used as a quality indicator in trauma care. The trauma tertiary survey (TTS) has been proposed to reduce missed injuries. However a systematic review assessing the effect of the TTS on missed injury rates in trauma patients found only observational studies, only suggesting a possible increase in early detection and reduction in missed injuries, with significant potential biases. Therefore, more robust methods are necessary to test whether implementation of a formal TTS will increase early in-hospital injury detection, decrease delayed diagnosis and decrease missed injuries after hospital discharge. METHODS/

designWe propose a cluster-randomised, controlled trial to evaluate trauma care enhanced with a formalised TTS procedure. Currently, 20 to 25% of trauma patients routinely have a TTS performed. We expect this to increase to at least 75%. The design is for 6,380 multi-trauma patients in approximately 16 hospitals recruited over 24 months. In the first 12 months, patients will be randomised (by hospital) and allocated 1:1 to receive either the intervention (Group 1) or usual care (Group 2). The recruitment for the second 12 months will entail Group 1 hospitals continuing the TTS, and the Group 2 hospitals beginning it to enable estimates of the persistence of the intervention. The intervention is complex: implementation of formal TTS form, small group education, and executive directive to mandate both. Outcome data will be prospectively collected from (electronic) medical records and patient (telephone follow-up) questionnaires. Missed injuries will be adjudicated by a blinded expert panel. The primary outcome is missed injuries after hospital discharge; secondary outcomes are maintenance of the intervention effect, in-hospital missed injuries, tertiary survey performance rate, hospital and ICU bed days, interventions required for missed injuries, advanced diagnostic imaging requirements, readmissions to hospital, days of work and quality of life (EQ-5D-5 L) and mortality. DISCUSSION: The findings of this study may alter the delivery of international trauma care. If formal TTS is (cost-) effective this intervention should be implemented widely. If not, where already partly implemented, it should be abandoned. Study findings will be disseminated widely to relevant clinicians and health funders.

trial registrationANZCTR: ACTRN12613001218785, prospectively registered, 5 November 2013.

Indexed as

AustraliaBlood Chemical AnalysisClinical ProtocolsCost-Benefit AnalysisDiagnostic ErrorsDiagnostic ImagingElectronic Health RecordsHospital CostsHumansMultiple TraumaPhysical ExaminationPredictive Value of TestsProspective StudiesQuality Indicators, Health CareResearch DesignTertiary Care Centers

Identifiers

PMID25968303
PMCPMC4449594
OpenAlexW1845797302

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.