Outcomes in emergency care research
Publication in refereed journal


摘要As emergency physicians and clinicians, we are naturally concerned with the immediate results and diagnoses that we make in our daily clinical lives 1–5. Most of us are interested in the immediate survival of our critically ill patients and whether or not they are admitted to a critical care facility. Emergency care should be more than a salvage operation though, and we are becoming increasingly interested in outcomes other than simple survival or death.
Mortality is an attractively simple outcome, and it is readily measured 6,7; there are few instances of ‘half-dead’ persons (although some clinicians and teachers may argue with that!). However, its simplicity is its downfall – what we really need to know is how well a patient survived, or, in other words, how well they recovered from their illness or injury.
Outcomes other than survival have been studied most frequently in trauma 8–10, acute stroke, and specific musculoskeletal conditions (commonly the major arthritides). Challenges rapidly arise with respect to what aspects of outcomes to study; how does the researcher measure those outcomes; which outcome measurements are valid and reproducible; and which aspects of outcome are really important, be that to the patient, the healthcare system, the community, the family of the patient, or another reference point.
Other important conditions relevant to emergency medicine have not been adequately studied so far. The outcomes of sepsis patients are largely unknown, although critical illness outcomes have been studied and there are considerable overlaps. Part of the difficulty is the huge range of outcome measurement tools that are available – measuring in the hundreds and thousands. Many of these tools have been derived and developed in one setting, but never validated or tested for applicability in other settings. This is particularly so in the emergency setting where little attention has been paid to this so far.
Another crucial group for outcome assessment is ourselves, the emergency physicians 11,12. We are only beginning to track the career pathways and outcomes of emergency physicians having a full-length career in the specialty. We need to gather these data urgently to inform our managers and our career advisors on the needs and expectations of a career in emergency medicine in the 21st century.
As we enter 2017, there is much to be done. Will 2017 be the year we finally begin to look closely at the softer endpoints of what we do as emergency clinicians?
著者Hung KKC, Lo RSL, Grahahm CA
期刊名稱European Journal of Emergency Medicine
出版社Lippincott, Williams & Wilkins
頁次1 - 1

上次更新時間 2020-22-11 於 00:26