Research perspectives outlined in international publications analyzing medical aid and evacuation measures in emergency (armed conflicts)

Relevance. The statistics of armed conflicts across the world shows no decrease, causing large numbers of casualties. This compels military medicine professionals to intensify the study of accumulated experience regarding medical aid and evacuation support in combat and emergency settings.

The objective is to analyze research perspectives outlined in academic papers published in international journals from 2005 to 2022 and dealing with medical aid and evacuation in emergency scenarios (armed conflicts).

Methods. The study analyzes 1.496 international research papers dealing with medical aid and evacuation support management in military forces across the world. All the papers are published in peer-reviewed journals and registered in the PubMed database. The VOSviewer program was used for cluster analysis and visualization of keyword co-occurrences.

Results and discussion. In the VOSviewer, keywords were assigned across 6 clusters. Cluster 1 included 28.7 % of publications on general issues of military medicine with the total link strength of 26.4 % in the total study sample, followed by cluster 2 on medical aid and evacuation efforts in emergency situations (19.8 % and 18.9 %, respectively), cluster 3 on therapies and evacuation efforts in combat injuries (16.3 % and 18.7 %), cluster 4 on medevac operations (13.7 % and 13.7 %), cluster 5 on medical aid and evacuation efforts in the USA (11.7 % and 12.8 %), and cluster 6 on emergency medical care in armed conflicts (9.8 % and 9.7 %, respectively). The analysis allowed to identify mainstream international research schools that set the trend in medical aid and evacuation amid emergencies (armed conflicts).

Conclusion. Bibliometric databases are a universal tool allowing to expand the scope of research and determine the mainstream trends in military medicine for a particular timespan. The studies by international investigators can useful for Russian military medicine professionals, including comparative studies on medical aid and evacuation efficiency in different countries.

1. Evdokimov V.I., Shamrey V.K., Pluzhnik M.S. Boevoj stress: analysis of scientific research directions (2005–2021). St. Petersburg. 2023. 98 p.

2. Evdokimov V.I., Shamrey V.K., Pluzhnik M.S. Boevoj stress: analiz inostrannyh statej pri pomoshhi adaptacii rezul’tatov programmy VOSviewer (2005–2021 gg.) [Combat stress research prospects in Russian academic publications analyzed using to VOSviewer software (2005–2021)]. Mediko-biologicheskie i social’no-psihologicheskie problemy bezopasnosti v chrezvychajnyh situacijah [Medicо-Biological and Socio-Psychological Problems of Safety in Emergency Situations]. 2023; (3):106–121. DOI: 10.25016/2541-7487-2023-0-3-106-121. (In Russ)

3. Kalachev O.V., Papkov A.Ju., Tokmakov M.A. [et al.]. O neobhodimosti preobrazovanija sistemy medicinskogo obespechenija vojsk (sil) v sovremennyh uslovijah [On the need to transform the system of medical support for troops (forces) inmodern conditions]. Voenno-meditsinskii zhurnal [Military medical journal]. 2024; 345(2):4–8. (In Russ)

4. Tsygan V.N., Kul’nev S.V., Porohov S.Ju. Professor Anatolij Mihajlovich Shelepov – osnovatel’ nauchnoj shkoly organizatorov voennogo zdravoohranenija (k 70-letiju) [Professor Anatoly Mikhailovich Shelepov – founder of the scientific school of military healthcare administrators (to the 70th anniversary)]. Vestnik Rossijskoj voenno-medicinskoj akademii [Bulletin of Russian Military medical Academy]. 2020; 22(3):275–278. (In Russ)

5. Allied joint doctrine for medical support. Allied joint Publication. NATO standardization office (NSO). 2019. 124 p.

6. Apodaca A., Olson C.M., Bailey J. [et al.]. Performance improvement evaluation of forward aeromedical evacuation platforms in Operation Enduring Freedom. J. Trauma Acute Care Surg. 2013; 75(2, suppl. 2):S157–S163. DOI: 10.1097/TA.0b013e318299da3e.

7. Army Futures Command Concept for Medical 2028. 50 p.

8. Bagg M., Covey D., Powell E. Levels of medical care in the global war on terrorism. J. Am. Acad. Orthop. Surg. 2006; 14(10 Spec.):S7–S9. DOI: 10.5435/00124635-200600001-00003.

9. Bricknell M., Horne S. Personal view: security sector health systems and global health. BMJ Mil. Health. 2023; 169(e1):e64–e67. DOI: 10.1136/bmjmilitary-2020-001607.

10. Bricknell M., Johnson A. Forward Medical Evacuation. BMJ Mil. Health. 2011; 157(Suppl. 4):S444–S448.

11. FM 4-02, Army Health System, 17 November 2020. 232 p.

12. Global Peace Index 2023. Institute for Economics & Peace Measuring peace in a complex world. 96 p.

13. Leone R., Homan Z., Lelong A. [et al.]. An Analysis of International Military Health Systems Using the Military Medical Corps Worldwide Almanac. Mil. Med. 2021; 186(9-10):e1017-e1023. DOI: 10.1093/milmed/usaa376.

14. Leone R., Whitaker J., Homan Z. [et al.]. Framework for the evaluation of military health systems. BMJ Mil. Health. 2023; 169(3):280–284. DOI: 10.1136/bmjmilitary-2020-001699.

15. Ponsin P., Swiech A., Poyat C. [et al.]. Strategic air medical evacuation of critically ill patients involving an intensive care physician: A retrospective analysis of 16 years of mission data. Injury. 2021; 52(5):1176–1182. DOI: 10.1016/j.injury.2020.10.010.

16. Shawn D., Pettersson Th., Цberg M. Organized violence 1989-2022, and the return of conflicts between states. J. Peace Research. 2023; 60(4):691–708. DOI: 10.1177/00223433231185169.

17. SIPRI Yearbook 2023: Armaments, Disarmament and International Security: Summary. Oxford University Press, 2023. 24 p.

18. Van Eck N.J., Waltman L. Manual for VOSviewer version 1.6.19. Leiden Universiteit. 2023. 54 p. URL: https://www.aidi-ahmi.com/download/Manual_VOSviewer_1.6.19.pdf.

19. Van Eck N.J., Waltman L. Software Survey: VOSviewer, a Computer Program for Bibliometric Mapping. Scientometrics. 2010; 84(22):523–538. DOI: 10.1007/s11192-009-0146-3.