Evidence Based Military Medicine : The NATO Trauma Registry Initiative

Abstract

For thousands of years Medicine was practiced in empiric and authoritarian ways. Physicians and other medical personnel always treated sick people with the principle of “nil nocere”, meaning “do no harm”, but the procedures sometimes either were not effective or did cause harm. Modern scientific methods in medicine enabled the scientists to provide firm results and evidence of a particular treatment or procedure in health care provisions. In a controlled clinical environment the prospective, double blinded, multi– centric, randomized trial became the golden standard of research, because this method provided the most solid basis of testing a hypothesis. In Military Medicine the operational environment and battle rhythm define the framework for the practice. It is impossible to design a trial with all the aforementioned requirements in battlefield settings, however small scope prospective trauma care studies are now getting approval and some of them have been already published. The tools for this research are the national Military Trauma Registry Systems, which are available now in a few countries. The NATO Trauma Registry Initiative is a multinational effort for the exchange of operational trauma care data among the NATO Military Medical Services, to foster the improvement of Military Medicine and to provide more solid evidence for treatment.