Abstract
Background: Gaps in research evidence lead to research waste. In burn treatments, there is a paucity of reliable evidence or data. This contributes to inconsistent patient care, especially on a global scale, where low-resource countries often lack access to the latest research advancements. This umbrella review was undertaken as part of the James Lind Alliance Priorities in Global Burns Research Priorities Setting Partnership (PSP), and aimed to identify and assess the quality of evidence in thermal burns care. The objective was to map which interventions in thermal burn care are supported by a reliable evidence base, and for which the evidence is lacking.
Methods: Systematic reviews of randomised controlled trials in thermal burns were identified and assessed using reliability criteria determined a priori. Multiple systematic review databases were searched in June 2023, including The Cochrane Library, KSR Evidence database and NIHR Journals Library. Summary of findings and, where available, GRADE was used to assess certainty of evidence. Reliable reviews were mapped onto clinical categories identified by patients, carers and healthcare professionals as part of the PSP.
Results: Two hundred and thirty two systematic reviews were identified, of which 83 met reliability criteria and were included. The main reason for not meeting reliability criteria was poorly defined eligibility criteria (n=128). Of the 83 reliable reviews, most were conducted in pain (n=28) or wound management (n=14) and acute care (n=13). Certainty of evidence was mixed. Reviews mapped onto
9 of the 17 clinical categories identified by the PSP.
Conclusion: This review summarises the available high quality evidence in burns care, and identifies evidence gaps, indicating many important clinical questions remain unanswered. There is a discrepancy between the treatments investigated in high quality research and the clinical areas considered most important to stakeholders. These findings provides direction for future research to improve global burn care.
Methods: Systematic reviews of randomised controlled trials in thermal burns were identified and assessed using reliability criteria determined a priori. Multiple systematic review databases were searched in June 2023, including The Cochrane Library, KSR Evidence database and NIHR Journals Library. Summary of findings and, where available, GRADE was used to assess certainty of evidence. Reliable reviews were mapped onto clinical categories identified by patients, carers and healthcare professionals as part of the PSP.
Results: Two hundred and thirty two systematic reviews were identified, of which 83 met reliability criteria and were included. The main reason for not meeting reliability criteria was poorly defined eligibility criteria (n=128). Of the 83 reliable reviews, most were conducted in pain (n=28) or wound management (n=14) and acute care (n=13). Certainty of evidence was mixed. Reviews mapped onto
9 of the 17 clinical categories identified by the PSP.
Conclusion: This review summarises the available high quality evidence in burns care, and identifies evidence gaps, indicating many important clinical questions remain unanswered. There is a discrepancy between the treatments investigated in high quality research and the clinical areas considered most important to stakeholders. These findings provides direction for future research to improve global burn care.
| Original language | English |
|---|---|
| Article number | e094303 |
| Number of pages | 12 |
| Journal | BMJ Open |
| Volume | 15 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - 25 Jun 2025 |
Bibliographical note
Publisher Copyright:© 2025 Author(s.
Keywords
- Systematic review
- intensive and critical care
- surgery