We at our institution have developed a protocol to deal with terror attacks . Now how can i confirm scientifically that my protocol has actually improved the outcome of the incident in term of mortality and morbidity owing to better patient disaster management plan ?
International studies just describe an event and then discuss the outcomes - no set protocols yet!!
need guidance
Thank you very much . Actually thought of comparison between two facilities but terror attack practice guideline cannot be compared in different hospitals since the architecture, size of facility, number of beds are different and I would need to compare two exactly similar facilities . thanks anyway . I'd request you help me further after i go through the lliterature again
regards
For this specific purpose the historical control of your own facility has to be used and you can compare various factors like time factors etc besides orbidity and mortality.
sir similar study is being planned in pathology department. they r implementing a system for histopathology section and r looking for reduction in errors after its implementation. its comparative cross sectional type design.
Dear Ahmad
I think it would be wrong to expect to truly prove superior results with your new protocol.
The most important outcomes for the patients would be survival and then things like long-term quality of life within multiple domains (cognition, return-to-work etc). Further down the line it would be secondary outcomes like length-of-stay (ICU/hospital), days on respirator etc but these would mean less to the patient and more to everyone around him/her (including whoever pays for it all).
Testing new protocols scientifically mostly ends up with measuring outcomes like compliance to the protocol, times between events etc, which means little to the patient if it can't be converted into those outcomes I mentioned (and possibly others of course). For exemple, see what's written on the WHO checklist for surgery in NEJM, and you'll see that it's not as simple as we would all like to think to prove superiority.
Just my 2 cents...
Very best
Johan
Dear Ahmad
I think it would be wrong to expect to truly prove superior results with your new protocol.
The most important outcomes for the patients would be survival and then things like long-term quality of life within multiple domains (cognition, return-to-work etc). Further down the line it would be secondary outcomes like length-of-stay (ICU/hospital), days on respirator etc but these would mean less to the patient and more to everyone around him/her (including whoever pays for it all).
Testing new protocols scientifically mostly ends up with measuring outcomes like compliance to the protocol, times between events etc, which means little to the patient if it can't be converted into those outcomes I mentioned (and possibly others of course). For exemple, see what's written on the WHO checklist for surgery in NEJM, and you'll see that it's not as simple as we would all like to think to prove superiority.
Just my 2 cents...
Very best
Johan
http://www.ncbi.nlm.nih.gov/pubmed/24620866
Maybe you first do a metaanalysis on which factors are independent parameters followed by data with your new protocol compared historically in your own centre.
Hello Sir Ahmad,
I think Martin has give the best answer, For a horter study period , I would say if you have confidence in your protocol and it is approved by a board.
Feel free to take it to other Hospitals in Lahore and possibly even peshawar to become a part of your trial.
This way you can test it more quickly in real terrorist attack incident, other wise I think it will be very hard to get data only from Mayo Hospital , can take years to have substantial evidence through one hospital as no of such incidents in proximity of one hospital is one in many years.
Best
Waqar
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