Milton, A., Drake, T.M. and Lee, M.J. (2019) The current status of clinical trials in emergency gastrointestinal surgery. A systematic analysis of contemporary clinical trials. Journal of Trauma and Acute Care Surgery, 86 (3). pp. 524-531. ISSN 2163-0755
Abstract
BACKGROUND: Emergency gastrointestinal surgery (EGS) conditions represent a significant healthcare burden globally requiring emergency operations that are associated with mortality rates as high as 80%. EGS is currently focussed on quality improvement and internal audits, which occurs at a national or local level. An appreciation of what EGS trials are being conducted is important to reduce research wastage and develop coordinated research strategies in surgery. The primary aim of this study was to identify and quantify recent and active trials in emergency gastrointestinal surgery. The secondary aim was to identify conditions of interest, and which aspects of care were being modified. METHODS: A systematic search of WHO, UK, US, Australian and Canadian trials databases was undertaken using broad terms to identify studies addressing emergency abdominal surgery and specific high-risk diagnoses. Studies registered between 2013-2018 were eligible for inclusion. Data on study topic, design, and funding body were collected. Interventions were classified into 'peri-operative', 'procedural', 'post-operative', 'non-surgical' and 'other' categories. RESULTS: Searches identified 5603 registered trials. After removal of duplicates, 4492 studies remained and 42 were eligible for inclusion. Almost 50% of trials were located in Europe and 17% (n=7) in the USA. The most common condition addressed was acute appendicitis (n=11), with the most common intervention being procedure based (n=23). Hospital based funding was the most common funder (n=30). CONCLUSION: There is large disparity in the number of surgical trials in emergency surgery, which are primarily focussed on high-volume conditions. More research is needed into high-mortality conditions. EVIDENCE LEVEL: 1a (oxford).
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2019 Lippincott Williams & Wilkins, Inc. This is an author produced version of a paper subsequently published in Journal of Trauma and Acute Care Surgery. Uploaded in accordance with the publisher's self-archiving policy. |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > The Medical School (Sheffield) > Academic Unit of Medical Education (Sheffield) |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 04 Feb 2019 11:30 |
Last Modified: | 16 Nov 2021 14:45 |
Status: | Published |
Publisher: | Wolters Kluwer |
Refereed: | Yes |
Identification Number: | 10.1097/TA.0000000000002123 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:141961 |