Pediatric emergency medicine research: a critical evaluation

A measure of research activity is an important way to gauge knowledge advances. We designed this study to analyze trends in pediatric emergency medicine (PEM) research, particularly focusing on the amount of research presented, topics investigated, location of research presentation, study design, and use of statistical analysis.

Every abstract presented between January 1987 and December 1999 from 4 national scientific meetings [Ambulatory Pediatric Association (APA), American Academy of Pediatrics (AAP), American College of Emergency Physicians (ACEP), and Society for Academic Emergency Medicine (SAEM)] was evaluated. Those abstracts that met study criteria were evaluated for research topic, year of presentation, and sponsoring organization. Abstracts from the first and last 5 years of the study period were assessed for study design and use of statistical analysis. Trends over time were examined.

There were 1675 abstracts presented over the 13-year study period: 41% at APA, 27% at AAP, 7% at ACEP, and 25% at AEM. Medical topics were most frequently investigated (36%) followed by trauma (20%), administrative (17%), procedural (14%), life-threatening emergencies (12%), and surgical (3%). Two percent of abstracts was presented in the first year and the greatest proportion (14%) was presented in 1999 (P < 0.001). Eighty percent of the abstracts was assessed for study design and use of statistics. There was no change in the proportion of abstracts that were prospective [odds ratio (OR) = 0.98 (95% confidence interval (CI) = 0.76-1.26)] or analytic [OR = 1.06 (95% CI = 0.83-1.35)] between the early and the later years. Descriptive surveys increased in frequency from the early to the later years [OR = 1.92 (95% CI = 1.29-2.92)] as did multicentered clinical trials [OR = 7.71 (95% CI = 1.97-66.38)]. Case series decreased in frequency [OR = 0.71 (95% CI = 0.54-0.93)] as did bench research [OR = 0.21 (95% CI = 0.11-0.40)]. The use of statistics increased with time [OR = 1.99 (95% CI = 1.54-2.58)] as did the use of CIs [OR = 4.40 (95% CI = 2.76-7.29)].

There was a substantial increase in the amount of research conducted in PEM. The topics investigated correspond to national recommendations. There was not an increase in the amount of research that was prospective or analytic in nature; however, there was increased statistical sophistication with time.