Ausserer J, Abt T, Stadlbauer K H, Paal P, Kreutziger J, Lindner K H, Wenzel V
Univ.-Klinik für Anästhesie und Intensivmedizin, Medizinische Universität Innsbruck, Anichstr. 35, 6020, Innsbruck, Österreich.
Anaesthesist. 2014 Jan;63(1):54-61. doi: 10.1007/s00101-013-2259-6.
Only randomized clinical trials can improve the outcome of life-threatening injuries or diseases but observations from England and North America suggest that the number of such randomized clinical trials is decreasing. In this study contributions from German speaking countries with regards to randomized clinical trials in emergency medicine over the last 22 years were investigated.
The Medline database was searched from January 1990 to December 2012 for prospective randomized clinical trials in the prehospital setting using the criteria "cardiac arrest", "cardiopulmonary resuscitation", "multiple trauma", "hemorrhagic shock", "head trauma", "stroke" as well as myocardial infarction and emergency medical service. Only studies originating from Germany, Austria or Switzerland were included.
A total of 474 studies were found and 25 studies (5.3 %) fulfilled the inclusion criteria. In the last 22 years German speaking countries have published approximately one prospective, randomized, clinical trial per year on prehospital emergency medicine. The median number of patients included in the trials was 159 (minimum 16, maximum 1,219). Most (80 %) studies originated from Germany and most (64 %) studies were conducted by anesthesiology departments. Cardiac arrest was the most frequent subject of the investigated studies. Approximately 50 % of the studies had financial support from industrial companies.
A significant increase or decrease in the number of prospective randomized clinical trials in the out-of-hospital setting could not be found in German speaking countries despite the fact that the absolute numbers of studies had increased. Only about one prospective, randomized clinical trial with an emergency medicine core tracer diagnosis originated from Germany, Austria and Switzerland per year.
只有随机临床试验才能改善危及生命的损伤或疾病的治疗结果，但来自英国和北美的观察结果表明，此类随机临床试验的数量正在减少。在本研究中，调查了过去22年中德语国家在急诊医学随机临床试验方面的贡献。
检索1990年1月至2012年12月的Medline数据库，以查找院前环境中的前瞻性随机临床试验，使用的标准为“心脏骤停”“心肺复苏”“多发伤”“失血性休克”“头部创伤”“中风”以及心肌梗死和紧急医疗服务。仅纳入来自德国、奥地利或瑞士的研究。
共找到474项研究，25项研究（5.3%）符合纳入标准。在过去22年中，德语国家每年发表约一项关于院前急诊医学的前瞻性随机临床试验。试验纳入患者的中位数为159例（最少16例，最多1219例）。大多数（80%）研究来自德国，大多数（64%）研究由麻醉科进行。心脏骤停是所调查研究中最常见的主题。约50%的研究获得了工业公司的资金支持。
尽管研究的绝对数量有所增加，但在德语国家未发现院外环境中前瞻性随机临床试验数量有显著增加或减少。每年仅约有一项以急诊医学核心示踪诊断为基础的前瞻性随机临床试验来自德国、奥地利和瑞士。
