So, what exactly do you mean by disaster medicine?

Sarin, R., Hick, J., Livinski, A., Nieratko, J., Treber, M., Mazurek, A., . . . Goralnick, E. (2019). Disaster Medicine: A Comprehensive Review of the Literature From 2016. Disaster Medicine and Public Health Preparedness, 13(5-6), 946-957. doi:10.1017/dmp.2019.18

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(Well, it's hard to define, hard to research, hard to apply the research, and it needs more research. How's that?)

Context: Researchers teamed up from the Society of Academic Emergency Medicine, The National Institutes of Health, and the Office of the Assistant Secretary for Preparedness and Response - Technical Resources, Assistance Center, and Information Exchange (ASPR-TRACIE) for an annual review of the most important disaster medicine literature. Disaster management is growing in importance, interest, and professionalization. What comprises this field is one question. The authors use this helpful definition in their search: “…providing health care to disaster survivors and providing medically related disaster preparation, planning, response, and recovery support and leadership regardless of the causative hazard." The answers also help to define and describe the field (see conclusions). So if any of that is of interest to you, this objective certainly will be as well: "The question of what the most important articles are to read within one's limited time becomes important."

Methods: This is a comprehensive literature review of all major disaster and emergency medicine publications, as well as a wide body of gray literature. 1175 articles were screened, 565 had the full text reviewed, and a thorough, predetermined rating system applied to yield 18 publications in the final review.

Conclusions: Anecdotal, single institution reports predominated, leading the authors to conclude that, while anecdotal evidence has value, disaster research could hopefully progress to include original research "in the form of randomized controlled trials, meta-analyses, interventional studies, cohort analyses, epidemiological assessments, cost-effective analyses, and others."

Disaster medicine is broad and includes emergency medicine, emergency management, trauma care, and global medicine. The reviewed papers highlighted responses to Ebola (2 papers), mass violence (3), hurricanes (2), earthquakes (3); research frameworks (2), psychological effects (2), Emergency Department adaptation (1), regulatory changes (1), and best practices (2). The authors call for more precision in defining disaster medicine and its scope. They urged collaboration and organization in research. They suggest more standardization in education.

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“In some cases, there is no substitute for descriptive learning from novel events, and a balance must be struck in the scoring systems to account for this tension between clinical value and academic rigor.”