MATTS
Research type
Research Study
Full title
MATTS (Major Trauma Triage Tool Study)\n
IRAS ID
254609
Contact name
Gordon Fuller
Contact email
Sponsor organisation
University of Sheffield
Clinicaltrials.gov Identifier
17968752, ISRCTN
Duration of Study in the UK
2 years, 6 months, 31 days
Research summary
Serious injuries are a major health problem in England, responsible for 3,000 deaths and 8,000 disabilities each year. Treatment in specialist hospitals, called major trauma centres, can improve survival following such injuries. In order to benefit from this expert care, ambulance crews must first correctly identify suitable patients at the scene of injury and then transport them to a major trauma centre, potentially bypassing closer non-specialist hospitals.\n\nThe presence of serious injury is not always obvious and assessment can be difficult. Taking patients with minor injuries to the major trauma centre could waste time, money and resources; denying treatment to those who require it by overstretching the capacity of the major trauma centre. It could also inconvenience patients and their families by taking them further from home. In contrast, failing to recognise serious injury could result in less effective treatment or increased harm.\n\nThe term ‘triage’ means to sort patients in terms of priority. Ambulance crews currently use a ‘triage tool’ to help them to recognise whether a patient is seriously injured or not. The tool is a checklist of patient and injury features, for example the presence of low blood pressure, that indicate that care in a major trauma centre care might be beneficial. Unfortunately, research has suggested that current tools are not very accurate, as they could miss patients with serious injury and often unnecessarily direct patients with more minor injuries to a major trauma centre. This study aims to develop a new and more accurate tool that will help to ensure that the right patient gets to the right place at the right time.\n\nWe will carefully study existing triage tools used in England and world-wide. We will also use data already collected by ambulance services and the English national major trauma database (the Trauma Audit and Research Network, TARN) to investigate what factors are important for detecting serious injury at the scene of the incident. Additionally we will develop a computer model that simulates the costs and outcomes of using different triage tools. Together, we will take this information to a group of experts and ask them to develop a new triage tool.\n\nWe will then test the experts’ triage tool, together with other existing tools, to see how they perform. In order to do this we will link data that is routinely collected by the Yorkshire, West Midlands, South Western and London Ambulance services, with hospital information collected by TARN. It has been suggested that identifying major trauma in older people is particularly difficult, so we will also specifically focus on this age group. We will then take the best-performing tool and introduce it into practice in an area of each ambulance service, to see how it works in real life. To find out about the experiences and views of patients, and paramedics using the tool, we will carry out interviews and focus groups. We will also consult with major trauma specialists, service managers and other stakeholders to assess the possible impact of the tool.\n\nWe have talked to patients affected by serious injury, and a group of patients involved in research about emergency care, while developing these research ideas. Members of these groups have agreed to join an advisory panel to help guide any future study. We have included a lay person with personal experience of major trauma as part of our research team alongside specialists in emergency medicine, pre-hospital practice, and major trauma. We have also consulted national specialist groups and gained support from participating ambulance services.\n
REC name
Yorkshire & The Humber - Bradford Leeds Research Ethics Committee
REC reference
19/YH/0197
Date of REC Opinion
28 Jun 2019
REC opinion
Favourable Opinion