Trauma research forum

Parallel to the start of this year’s London Trauma Conference, a session dedicated to trauma research was introduced and hosted by Professor Karim Brohi. Titled “London Trauma Research Forum”, the program was devised as a day showcasing trauma research across the London Trauma System. In his opening address Prof. Brohi emphasised that the development of the London trauma system is a unique opportunity to strengthen trauma research. The resources spent on trauma related research compare poorly to other fields of medicine and are not in proportion to the resources devoted to the clinical management of trauma by far. This is disappointing as trauma is the only current disease in the UK with an increasing mortality rate. The propensity for trauma to affect young adults, adds to the societal burden of this disease. The evidence base and the quality of research for the management of severe trauma is not impressive, and while the annual rate of academic contribution to this clinical field may be beyond the scope of a journal’s special issue, it probably wouldn’t overwhelm any librarian. However, to criticise the allocators of resources for this imbalance may be misplaced. On the contrary, the main issue may be a lack of academic initiatives from the trauma community itself; well formulated applications describing well founded topics, high quality projects and large scale trials, will secure funding for research related to trauma as it secures resources for research in any other field of medicine. There are many reasons why such applications are scarce from the trauma community. Trauma is an acute disease often occurring in a chaotic environment where issues such as informed consent, randomization and detailed documentation may be in direct ethical or time dependent contrast to effective clinical management. As the new London trauma system (http://www.londontraumaoffice.nhs.uk/) is developing into the largest formalized network of trauma care in the world, this should be paired with expectations of evening out the imbalance between the societal burden of trauma and the efforts towards improving trauma care. The London trauma system will have mandatory data admission to the TARN database (https://www.tarn.ac.uk/ ). This will secure a unique combination population-based and detailed clinical data from an extensive population. This, combined with the ability to follow a patient’s course through all the phases of trauma care within the system, enables clinical trials and observational studies with a magnitude and with a closed-loop quality that is truly unique. It is evident from the speakers in the research symposium that it is not just patient data which is united with the development of a trauma system. Diversity is a key word describing the research forums topics and researchers. The first session, titled “Systems Research & Clinical Trials” illustrated how current projects that have already reached clinical trial stage, may benefit from the higher patient volume following the centralization of trauma management. An example was given by Dr Howard Levy, who is currently conducting a stage 2b trial on a novel oxygen delivery compound. The study requires 300 carefully selected trauma patients. A trauma system should be under continuous audit and quality improvement. Tracy Parr from the London Trauma Office presented preliminary results assessing the precision of the newly implemented triage tool for pre-hospital personnel. In addition to testing the performance of the triage tool, the study has revealed important challenges and insights into linking data captured at the different phases of management – the necessity of a unique patient identification number is a lesson most certainly applicable to other regions with trauma system aspirations. How do we ensure that the research that is conducted leads to improved care? How much evidence do we need to implement, say, tranexamic acid in our treatment protocols? The implementation of research is an Norwegian Air Ambulance Foundation, Department of Research, Drøbak, Norway Full list of author information is available at the end of the article Kristiansen and Ringdal Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2012, 20(Suppl 1):I4 http://www.sjtrem.com/content/20/S1/I4