Before a randomized controlled trial (RCT) is performed, systematic reviews (SR) of the topic need to be cited to ensure new, meaningful information is being added. Studies that do not do this can cause wasted resources such as funding and time. We analyzed RCTs in the top emergency medicine journals for indication of SR citations. We searched PubMed for studies that were published between 01/01/2014 and 12/31/2017.

This search resulted in 615 studies. Of those 615 studies, we found that 275 of them fulfilled the requirements of a RCT. The bibliographies of the 275 studies were analyzed for evidence of SR citation. If a SR citation was present, we determined if information from the citation was used to justify the RCT. Of the 275 studies, we found that 66%, 95%, and 74% studies did not use SR citations as justification or did not have SR citations at all in the introduction, methods, and discussion sections respectively. The average sample size of each RCT was 294 participants. 40% of the studies did not report the type of funding, and 20% of studies received funding from government resources. The most common trial type was a parallel group trial contributing to 69% of our studies.

The results from this study reveal that there is a lack of justification for RCTs in emergency medicine research due to the underutilization of meaningful SR citations. Trialists in emergency medicine should be more proactive in citing SRs in their studies to prevent wasted resources.