Trauma treatments 'not effectively tested'
Wednesday, 06 Sep 2006 15:48
Trauma care trials 'ineffective'
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Effective trauma care is being undermined by a "severe lack" of clinical trials, a leading scientist warned today.
According to Professor Ian Roberts of the London School of Hygiene, injury kills and disables millions of people but doctors still do not know if the treatments they use actually work.
Trauma is second only to HIV and Aids as a cause of death for people aged between five and 45 years. Every day worldwide more than 300,000 people are severely injured, about 10,000 of whom die.
Road traffic accidents and violence are the leading causes of these injuries.
Speaking at the British Association for Advancement of Science's (BA) annual festival of science, Professor Roberts argued that "there is a severe lack of clinical trials in trauma care and the existing trials are small, contributing to uncertainty about effectiveness".
He said: "The public does not appreciate that most of the treatments for severe injury have never been properly tested."
Factors inhibiting effective trials, he believes, include less funding than for other causes of human suffering, injury being "a disease of poor people and soldiers" therefore not having the support of the wealthy and powerful, Good Clinical Practice requirements being geared towards the development of unlicensed drugs, and few countries having legislation in place for the special situation of trauma care trials.
"As a result, trauma patients are unfairly denied the benefits of medical research," Professor Roberts said.
He added: "We need large collaborations of equals rather than small groups of individualists [to improve the evidence base for trauma care]. Doctors and patients internationally can join these collaborations but we need ways to bring trials to their attention, we need to reduce the regulatory burden and appropriately reward collaboration.
"Most importantly, the mismatch between the funding for trauma research and the burden of injury must be addressed," he concluded.