Trial reportThe British journal of surgery2023
Standardized trauma intake form with clinical decision support prompts improves care and reduces mortality for seriously injured patients in non-tertiary hospitals in Ghana: stepped-wedge cluster randomized trial.
Trial report in The British journal of surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04547192 (Improving Initial Management of the Injured at Ghanaian District and Regional Hospitals With a Trauma Intake Form), which is not on this map. Cited by 12 papers, 2 of them syntheses that pooled it.
What it found
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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.
Improving Initial Management of the Injured at Ghanaian District and Regional Hospitals With a Trauma Intake Form
Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 13 citations in OpenAlex.
- Guidelines for Essential Trauma Care: Second Edition (2026).World journal of surgery · 2026Guideline
- Role of recruitment bias in stepped-wedge cluster randomised controlled trials: a systematic review.BMJ open · 2025Pooled it
- Towards sustaining a trauma quality improvement initiative in Ghana: results of a clinical trial.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Trial
- An evaluation of the Hawthorne effect in a clinical trial of trauma care in Ghana.World journal of surgery · 2024Trial
- Trial
- Care of Injured Children Compared to Adults at District and Regional Hospitals in Ghana and the Impact of a Trauma Intake Form: A Stepped-Wedge Cluster Randomized Trial.Journal of pediatric surgery · 2024Trial
- Differences in trauma care between district and regional hospitals and impact of a trauma intake form with decision support prompts in Ghana: A stepped-wedge cluster randomized trial.World journal of surgery · 2024Trial
- 2026 Donald Trunkey Lecture: strengthening care for the injured globally: successes, challenges, opportunities.Trauma surgery & acute care open · 2026Review
- Global emergency medicine: A scoping review of the literature from 2023.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2025Article
- Synthesizing the Evidence Base to Enhance Coordination between Humanitarian Mine Action and Emergency Care for Casualties of Explosive Ordnance and Explosive Weapons: A Scoping Review.Prehospital and disaster medicine · 2024Article
- Experiences of injured patients referred to higher levels of care after initial assessment and management at non-tertiary hospitals in Ghana.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2024Article
- Assessment and reassessment of injured patients at non-tertiary hospitals in Ghana: A stepped-wedge cluster randomized trial.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundThe WHO Trauma Care Checklist improved key performance indicators (KPIs) of trauma care at tertiary hospitals. A standardized trauma intake form (TIF) with real-time clinical decision support prompts was developed by adapting the WHO Trauma Care Checklist for use in smaller low- and middle-income country hospitals, where care is delivered by non-specialized providers and without trauma teams. This study aimed to determine the effectiveness of the TIF for improving KPIs in initial trauma care and reducing mortality at non-tertiary hospitals in Ghana.
methodsA stepped-wedge cluster randomized trial was conducted by stationing research assistants at emergency units of eight non-tertiary hospitals for 17.5 months to observe management of injured patients before and after introduction of the TIF. Differences in performance of KPIs in trauma care (primary outcomes) and mortality (secondary outcome) were estimated using generalized linear mixed regression models.
resultsManagement of 4077 injured patients was observed (2067 before TIF introduction, 2010 after). There was improvement in 14 of 16 primary survey and initial care KPIs after TIF introduction. Airway assessment increased from 72.9 to 98.4 per cent (adjusted OR 25.27, 95 per cent c.i. 2.47 to 258.94; P = 0.006) and breathing assessment from 62.1 to 96.8 per cent (adjusted OR 38.38, 4.84 to 304.69; P = 0.001). Documentation of important clinical data improved from 52.4 to 76.7 per cent (adjusted OR 2.14, 1.17 to 3.89; P = 0.013). The mortality rate decreased from 17.7 to 12.1 per cent among 302 patients (186 before, 116 after) with impaired physiology on arrival (hypotension or decreased level of consciousness) (adjusted OR 0.10, 0.02 to 0.56; P = 0.009).
conclusionThe TIF improved overall initial trauma care and reduced mortality for more seriously injured patients. REGISTRATION NUMBER: NCT04547192 (http://www.clinicaltrials.gov).
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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.