Many treatments for trauma and injury are 'untried and untested'

Badly injured people who suffer major trauma in traffic accidents and war are being given treatments that are untried and untested, according to a leading specialist in the field.

Ian Roberts, professor of public health at the London School of Hygiene and Tropical Medicine, said such injuries were a leading cause of death and disability, yet most trauma treatments were unproved Some treatments for traumatic injuries had been shown to increase the risk of death in patients yet they had been used for years despite there being unresolved questions about their safety, Professor Roberts said.

"The first large-scale clinical trial in head injury showed that corticosteroids - a treatment that has been used for over 30 years - was actually killing patients," Professor Roberts said.

The trial found that corticosteroids, an anti-inflammatory drug, increased the mortality of severely brain-damaged people by 3 per cent, which translated to thousands of excess deaths since the drug had been first used.

"That's industrial slaughter because thousands of patients have been killed by this drug," Professor Roberts told the British Association's annual meeting at the University of East Anglia in Norwich.

"People think trauma treatments are used because clinical trials have shown them to be effective. Not true. Doctors often use treatments because they think that they should work," he said.

Most randomised clinical trials involve treatments for diseases such as cancer which mostly affect elderly citizens of wealthier countries. Trauma and injury predominantly affects the young and the poor. "The main reason injury is overlooked by the medical research community is that it is a disease of poor people," Professor Roberts said. "It's a myth that accidents occur at random. In fact they are distinctly socially stratified."