The Emergency Medicine Literature is Tragic

This is a survey of the top twelve Emergency Medicine journals, as ranked by impact factor, providing a descriptive analysis of the features of the studies contained within.  The authors manually reviewed 330 articles and found a mere 8.8% were randomized studies.  Most (65.5%) were cross-sectional studies and 23.6% were cohort studies.  57.3% were prospective, 47.9% were from the U.S., and the minority of studies (31.2%) used informed consent or mentioned waivers of informed consent.

Compared with other fields, the surveyed EM literature was less likely to mention IRB approval, less likely to be prospective, less likely to be blinded and controlled, and enrolled fewer patients per study.

There are many barriers to research in the Emergency Deparment – particularly prospective, randomized, controlled research.  However, the establishment of an office for emergency services research at the National Institutes of Health may improve the ability of U.S. researchers to obtain grant funding.  

Of course, this will then only exacerbate the bias inherent in the already U.S.-centric published literature.


"Quality of publications in emergency medicine"

www.ncbi.nlm.nih.gov/pubmed/23041480