Index
Abstract
Dedication
Preface
Definition of EMS for this Document
Federal Agencies Can Help Advance EMS Research
Executive Summary
Introduction
History of EMS Research
The Present State of EMS Research
Overcoming the Barriers to EMS Research

• Primary Barriers: Developing Researchers
• Primary Barriers: Funding
• Secondary Barriers: Recognizing the Need for EMS Research
  • The Culture of EMS
  • EMS Systems
  • EMS Education
  • The Public and Policy Makers
  • EMS Professionals
• Secondary Barriers: Information Systems
  • Data Definitions
  • Hardware and Software Infrastructure
  • Data Set Linkages
  • Statistical Implications of Large Databases
• Secondary Barriers: Ethical Concerns
  • Principles
  • Informed Consent
  • IRBs and EMS Research
  • Valuing Individual Autonomy

Summary
Appendix A: The National EMS Research Agenda Writing Team
Appendix B: Organizations Invited to Participate in the National Review Team
Appendix C: Ethical Standards and IRB Requirements
Appendix D Inclusion Of Women And Minorities In Research Study Populations Involving Human Subjects
Inclusion Of Children As Participants In Research Involving Human Subjects
Appendix E: Bibliographic List of Internet Links
Appendix F: Published EMS Randomized Clinical Trials
References

Statistical Implications of Large Databases

Since there are only one or two large datasets of EMS patients in any state, there are important statistical implications. As more questions are asked, it is increasingly likely that a result will be positive based upon chance alone and not a real difference. Since there is not a second dataset with which to validate the results, it becomes impossible to tell which positive results are meaningful and which are statistical flukes. When EMS researchers conduct studies involving large state-based data sets, they will need to validate those studies by repeating them in other states or at a different time.