Dr. Michael Abernethy, chief flight physician for UW Med Flight and professor of emergency medicine, was invited to provide expert commentary in JAMA Open in response to a newly published cohort study out of Denmark comparing the use of examining the effect of helicopter vs ground EMS on 1-year mortality. Full commentary: http://bit.ly/3bsYWku
As a 30 year veteran of the HEMS industry and a thought-leader on on international HEMS and GEMS operations and policymaking, Dr. Abernethy was invited to by JAMA's editors to review the Danish study's design and comment on the difficulty/validity of similar studies done in the U.S., which has a long history of disparity in its HEMS and GEMS programs.
In his commentary, Abernethy outlines how comparative research studies, both in the U.S. and abroad, have struggled to accurately compare prehospital transport models since early 1980's, with many utilizing retrospective analyses of hospital and transport data. Confounding factors include quickly outdated analyses due to rapidly evolving technology and education; disparities in HEMS and GEMS programs at every level of oversight, including the education, training, and qualifications of medical crews; as well as regulatory and financial structures of each industry.
On the article by Alstrup et al, Abernethy notes the how the study limited its scope to a specific region and patient population in which the structure and capabilities of HEMS and GEMS were well defined. While the fragmented and disparate structure of HEMS and GEMS programs in the U.S. makes undertaking research challenging, in turn making it difficult for policymakers to translate research findings to regulatory action, analyses in the U.S. should be undertaken to mitigate bias and disparities in the existing literature. Given their potential to influence the care delivered to our communities, this is more important that ever.
As Abernethy reminds us with an opening quote from Marty Rubin's The Boiled Frog Syndrome, "Every line is the perfect length if you don’t measure it."
Michael Abernethy, MD, FAAEM, DRTM has as an international reputation as an EMS educator and clinician and has been an invited speaker in the UK, Ireland, Germany, Netherlands, Denmark, Cuba, Canada, France, Switzerland and Sweden. He is also faculty with ATACC and an examiner for the Diploma in Retrieval and Transfer Medicine with the Royal College of Surgeons in Edinburgh. He is available for media interviews and commentary, and can also be reached on Twitter: @FLTDOC1