The Australasian College for Emergency Medicine (ACEM; the College) is pleased to announce that a FACEM-led trial has been named as a joint winner of the 2021 ACTA Trial of the Year Award for a landmark study that showed that a ‘hands off’ approach is best to treat a collapsed lung.
The study, conducted by more than 100 clinical researchers in 39 hospitals, took home the award at the Clinical Trials 2021: National Tribute and Award Ceremony held in Melbourne last night (20 May).
First held in 2016, the Clinical Trials National Tribute and Award Ceremony brings together clinical trials champions across health, academia, industry and the wider community to honour the remarkable Australians who advance clinical practice and save or improve the lives of patients every year.
Researcher, Professor Diana Egerton-Warburton said, “It feels like we won an Oscar. I am so excited that we have won this award, the study got lost in the Covid period, which meant that we missed opportunity to have a national conversation about how this can be implemented.”
Every year an estimated 2500-3000 Australians present at hospital emergency departments suffering from a collapsed lung (pneumothorax).
For decades, doctors inserted a plastic tube into the patient’s chest to drain the collected air to help the lung reinflate. Not only is this treatment often painful, but it can lead to organ injury, bleeding, infection and sometimes additional surgery.
However, the study, that spanned six years and involved more than 300 Australian and New Zealand patients, determined that treating patients with simple pain relief, observing them and then sending them home to await the lung’s natural re-expansion and recovery lessens pain and significantly reduces injury, infection and time spent in hospital.
Professor Simon Brown, the study’s chief investigator and emergency physician said, the findings are a “game-changer.” He said, “This study found that medical intervention is not always in a patient’s best interest, and that if doctors step back and do less, patients do better.”
“We’ve been putting tubes into people with collapsed lungs since the beginning of the 20th century, thinking we were doing our best to treat the condition. Now, this study makes it clear that conservative treatment is the best approach, even when the lung collapse is large. Our study found that 85% of patients did extremely well with no intervention at all.
The findings are expected to cause a major shift in thinking around how doctors treat pneumothorax worldwide.
Professor Egerton-Warburton said, “We really want to use this award now to encourage clinicians to have conversations with their patients on how we can manage this common condition, which often occurs in young people.” She reiterated that it was, and is, a team approach.
“This was a great example of multidisciplinary research, with a number of teams (emergency medicine, respiratory medicine, cardiothoracic surgery, and clinical trials research staff) working together to get a fantastic result for patients.”
It is very exciting to see the rapid uptake of this study by The Therapeutic Guidelines (An independent national organisation proving therapeutic information to clinicians to help them make the best decisions for their patients) who now recommend conservative management in the first instance independent of size of the primary spontaneous pneumothorax.
ACEM President, Dr John Bonning, congratulated the recipients on their award. “It is important that we recognise and celebrate the many impressive achievements in our field of emergency medicine, across our two nations, and we are immensely proud of our members who contributed to this vital study showing how intervening less can be better for patients.”
Background:
ACEM is the peak body for emergency medicine in Australia and New Zealand, responsible for training emergency physicians and advancement of professional standards. www.acem.org.au