In order to identify the study designs andthe type of pre-trial peer review in published EMS research, we reviewed three refereed emergency medicine journals during the period from 1985 through 1988. All original scientific manuscripts utilizing human subjects in prehospital care were analyzed. Ninety-six issues were examined, and 79 manuscripts met the criteria for analysis. The research design was cross-sectional in 7.5%, retrospective in 51%, and prospective in 41.5%. Pre-trial peer review had been sought in nine (11%). Each was performed by a hospital or university-based Institutional Review Board (IRB). Only four (5%) manuscripts contained statements about pre-trial peer review. All reviewed trials were prospective in design (9/33, 27%). A follow-up telephone survey of the authors of the non-reviewed prospective trials indicated that 96% were unaware of the potential need for pre-trial review, 16% anticipated difficulty obtaining approval from traditional IRB committees, and 11% feared that the protocol would be interfered with by the review committee.
We conclude that 92.5% of the current published EMS research is retrospective or prospective in design, and that pre-trial peer review is not obtained in the majority of prehospital EMS research. Guidelines should be developed to educate EMS researchers about the need for and the value of pre-trial peer review. Journal editors should clearly state and enforce policies about manuscripts lacking information about pre-trial peer review when human subjects are involved.