Editorials

Regional trauma systems

BMJ 1997; 315 doi: https://doi.org/10.1136/bmj.315.7119.1321 (Published 22 November 1997) Cite this as: BMJ 1997;315:1321

The negative results from an evaluation do not tell the whole story

  1. David Yates, Professor of accident and emergency medicine
  1. a Hope Hospital, Salford M6 8HD

    In 1988 the Royal College of Surgeons published recommendations designed to improve the management of patients with major injuries.1 The Department of Health responded by supporting the development of a regional trauma service in North Staffordshire and commissioning an in depth analysis of its performance compared with the orthodox British model of care in two other centres in Lancashire and Humberside. Reviews were also undertaken of the cost effectiveness of helicopter ambulances and the role of minor injuries units. The college introduced courses in advanced trauma life support, and the Department of Health supported the extension of the major trauma outcome study, to provide comparative audit data on hospital performance.2

    Although the analysis of the regional trauma service examined outcomes in 1990-3, the article by Nicholl and Turner in this issue provides the first opportunity for the general reader to review the data (p 1349).3 Some will conclude that this delay is due either to publication bias against the negative results or to uncertainty about their validity when compared with the very positive earlier report from the Stoke clinicians.4 Whatever the reason, the paper provides an opportunity to …

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