Research in Emergency Medicine
1Emergency Medicine, Marmara University School of Medicine, Turkey
Emergency medicine research has a special place among other clinical branches with its structure directed towards the unknown between life and death. Randomized clinical trials for therapies to extend life-span or direct resuscitative efforts are quite rare. The most important reason for this is that it is not possible to conduct these studies ethically. Therefore, emergency medical research is squeezed between retrospective series, diagnostic valuation studies, survey studies and observational cohorts. Although all of these methods have reputable evidence base, they are often not sufficient to provide conclusive evidence. Therefore, more recent research techniques have been used. One of them is the propensity score analysis, and it is used to create balanced case and control groups in observational datasets which are collected prospectively or retrospectively. A propensity score is the probability that a unit with certain characteristics will be assigned to the treatment group (as opposed to the control group). The scores can be used to reduce or eliminate selection bias in observational studies by balancing covariates (the characteristics of participants) between treated and control groups. When the covariates are balanced, it become much easier to match participants with multiple characteristics. Another type of research design specific to emergency medicine is the studies that develop the rules of clinical decision making. In the last 20 years, numerous clinical decision-making rules have been published in the field of emergency medicine. The publication of guidelines on the technical standards of these studies has taken place only in the last 2-3 years. The development of a clinical decision-making rule is planned in 2 stages: development of the rule in the derivation cohort and testing in validation cohorts. This second stage is actually an infinite cycle: it is tested and compared in many special cases, such as different countries, patient subgroups, ages, races. Apart from these research designs, different research methods such as social network analysis, simulation study, case-cohort study will also be discussed.