Research Gaps in Wilderness Medicine.

Area of Science:

• Wilderness Medicine
• Clinical Practice Guidelines
• Evidence-Based Medicine

Background:

• Wilderness medicine requires specialized care in remote environments.
• Evidence-based clinical practice guidelines are crucial for optimal wilderness medical care.
• Identifying evidence gaps in these guidelines is essential for advancing the field.

Purpose of the Study:

• To identify evidence gaps within low-quality recommendations of wilderness medicine clinical practice guidelines.
• To identify new and ongoing research addressing these identified evidence gaps.

Main Methods:

• Reviewed clinical practice guidelines from the Wilderness Medical Society, focusing on 1C or 2C recommendations.
• Formulated Patient/Problem/Population, intervention, comparison, outcome (PICO) questions for each recommendation.
• Searched for relevant articles using 24 search strings and analyzed trial designs.

Main Results:

• Twelve guidelines yielded 275 low-quality recommendations and 275 PICO questions.
• Thirty-three articles were found relevant to the PICO questions.
• Heat-related illness had the most related articles (n=9); acute pain and altitude sickness had the most randomized trials (n=6).

Conclusions:

• Limited research is currently addressing identified evidence gaps in wilderness medicine.
• Heat-related illness shows the most ongoing research, while areas like eye injuries lack studies.
• Prioritizing research is recommended to fill critical evidence gaps in wilderness medicine.