Revisiting the "Scanty Science" of Prehospital Emergency Care 25 Years Later

We aimed to quantify the number of prehospital randomized controlled trials (RCTs) published in the 25 years since the Callaham editorial and review his perception of prehospital emergency care as "scanty" science.

We replicated Callaham's methods to retrieve publications related to prehospital randomized controlled trials (RCTs). This study systematically searched over 35 million citations cataloged by the National Library of Medicine in the PubMed Database between January 1, 1998, and December 31, 2022. Two independent reviewers screened titles, abstracts, and full manuscripts in two rounds, and key terms that indicated RCTs, such as randomized and controlled, standard, or placebo-controlled were identified.

The final study group of prehospital RCTs published between 1998 and 2022 included 141 papers. Of the 141 RCTs, 48.2% concluded no significant difference between the intervention and control groups. The average number of RCTs per year was 5.6. Trials during the study period were conducted in 19 different countries, and multinationally.

In the time period reported by Callaham, the average number of prehospital RCTs was 4.5 per year. The number of prehospital RCTs published per year has increased only slightly, to 5.6 per year, in the 25 years since Callaham described prehospital emergency care as a "scanty science."