1. Khaldoon AlKhaldi, MD Disaster medicine / Pre-Hospital care & International EMS Fellow BIDMC Harvard Medical schoo l Evolution of research production of Emergency Medicine in European Union Countries From 1995 to 2012 Presented by

2.  Medical research is essential for clinical practice, which plays an important role in improving the delivery of Health Care and making the treatment guidelines for diseases.  It’s enhancing the medical service system and increasing knowledge.  Research production is considering as an important indicator of the development of a country.  Shanghai ranking is fundamental indicator for strengthen of researches and shows the countries level in the world in terms of education. Introduction:

3. Objective of this study:  This study has the aim to describe and analyze the scientific production of EM in EU countries from 1995 to 2012 in EM journals with an impact factor close to 2 and above.

4. Material and Methods:  This is a descriptive study from 1995 to 2012 and the pattern of searching was manually for original articles published by EM teams who are working in EU EM departments or pre-hospital care (EMS).  The first Author name or the last author Name has to be from EU country and team of ED and the presence of word “ Emergency department” or word “ EMS, SAMU, SMUR or Air Ambulance Service” should be assigned with the those authors in the article.  The article should be produced from 1995 to 2012.

5. Items of article year of publication country of origine type of article ED EMS financial national grant EU grant international grant university hospital pharmaceutical Type of Study retrospective or prospectice monocentric or multi centric clinical or experimental meta-analysis Domain of article

6. Results:  EU Emergency Department and EMS published a total of 559 original articles from 19 EU countries.  Those original articles are from six EM journals in which have total of 1141 number of issues

7. Results:

9. Discussion :  From results obviously, the number of scientific production in EU is increasing in last years (2001-2012)  The main reason for this it’s probable related to the implementing Emergency Medicine as primary specialty with specialty-specific training programs and by 1999-2000 there were 9 European countries has EM specialty and by 2000-2010 there are 15 EU countries (Totten V, Bellou A. Development of emergency medicine in Europe. Acad Emerg Med. 2013 May;20(5):514-21)Totten VBellou A  UK has the majority of production 23.4% of the total (n=559) and it’s related to early recognition of accident and EM specialty.  UK has EM department with all facilities like staff, funds, residents, fellows and researchers.  This study has shown that only 30% from the total of articles are funded which is one of the limitation reasons in preventing the production of researches and quality level, however this study has shown the more of grants the more of production in Europe.  The main source of funding in this study was from national grants, which is 65% from the total (n=167)

10. Limitation of this study:  Emergencias is Spanish journal which started to English publishing in 2007.  We didn’t include all of articles published in EM journals with IF equal to one or below.  we didn’t compare the EU EM production to other continents production as America, Africa, Asia and Oceania  we didn’t look at the research production in the high level impact factor journals as New England Journal of Medicine, Lancet, Annals of internal Medicine, Jama, American Medical Journal, Circulation, Critical Care and Intensive care journals, European Journal of Cardiology, Heart.  we exclude some articles produced by the department of Anesthesia and related to EM

11. Conclusion:  The lack of EM residents and EM fellows in many EU countries could be considered a major handicap for the development of research.  The lack of a strong strategy on Research development as compared to other specialties is one of the reasons of EU EM low scientific production.  All EU countries must recognize EM as primary specialty.  Enhancement of emergency physician competitiveness to apply in national and EU grants for research projects must be encouraged.  Improve adequate representation of EU journals indexed in category of EM.  Finally, EM in Europe is developing and each year brings further advances and it’s the time to establish an EM network allover the word.