Evidence Based Military Medicine : The NATO Trauma Registry Initiative

For thousands of years Medicine was practiced in empiric and authoritarian ways. Physicians and other medical personnel always treated sick people with the principle of “nil nocere”, meaning “do no harm”, but the procedures sometimes either were not effective or did cause harm. Modern scientific methods in medicine enabled the scientists to provide firm results and evidence of a particular treatment or procedure in health care provisions. In a controlled clinical  environment the prospective, double blinded, multi– centric, randomized trial became the golden standard  of research, because this method provided  the most solid basis of testing a hypothesis. In  Military Medicine the operational environment and  battle rhythm define the framework for the practice.  It is impossible to design a trial with all the  aforementioned requirements in battlefield settings,  however small scope prospective trauma care studies  are now getting approval and some of them have  been already published. The tools for this research  are the national Military Trauma Registry Systems,  which are available now in a few countries. The NATO  Trauma Registry Initiative is a multinational effort for  the exchange of operational trauma care data among  the NATO Military Medical Services, to foster the  improvement of Military Medicine and to provide  more solid evidence for treatment.