Disaster medicine research ignores patient needs, study finds
A review of 28 studies reveals that researchers responding to humanitarian crises rarely involve affected communities in study design or prioritize their concerns—a gap that undermines both evidence quality and trust. As disasters become more frequent, this disconnect threatens the relevance and adoption of health interventions when they're needed most.
Originaltitel: Ethics and methods in disaster health research: a scoping review
**Katastrofmedicin behöver etisk omställning för att generera tillförlitlig evidens** Katastrofmedicinsk forskning genomfördes idag utan konsekvent etisk ramverk eller patientcentrerad utgångspunkt, vilket undergräver evidensbasen för kliniska och organisatoriska beslut vid kriser. En scoping review av 28 studier identifierar tre kritiska brister: etiska spänningar kring deltagarskydd i instabila miljöer, metodiska begränsningar som förhindrar robust datainsamling, och fragmenterad tillämpning av patientcentrerad vård. Studien, ledd av Krzysztof Goniewicz vid Polish Air Force Academy tillsammans med Sahlgrenska universitetssjukhuset och OsloMet, visar att katastrofmedicinen är "konceptuellt rik men strukturellt skör". Regulatoriska specialister och inköpschefer inom regionvård bör omvärdera etiska ramverk och metodiska protokoll för beredskapsstudier. Framåtskridande kräver adaptiva forskningsdesigner och explicit integration av patientcentrerad vård, särskilt i långvariga kriser där samordning mellan hälso- och socialtjänst är avgörande.
BACKGROUND: Disaster medicine operates in unstable, high-risk environments where operational, ethical, and contextual constraints frequently undermine traditional research designs. Although global health agendas increasingly emphasise person- and patient-centred care (PCC), these principles remain poorly articulated and rarely operationalised within disaster research. We aimed to examine how ethical tensions and methodological limitations shape the current disaster health research evidence base and explore how PCC might be meaningfully integrated into research design and governance. METHODS: We conducted a structured scoping review of peer-reviewed literature across PubMed, Scopus, and Web of Science, focusing on research methodology, ethics, and evidence generation in disaster and humanitarian contexts. We thematically synthesised the extracted data. RESULTS: We included 28 studies, identifying three cross-cutting thematic domains: ethical tensions related to participant vulnerability and governance in crisis settings; methodological constraints limiting the generation of robust, context-sensitive evidence; and inconsistent application of PCC principles. CONCLUSIONS: The evidence base for disaster medicine appears conceptually rich but structurally fragile. Ethical and methodological constraints suggest a critical gap in the operationalisation of PCC within disaster research. Advancing the field will likely require adaptive methodologies, context-responsive ethical oversight, and more explicit integration of person-centred principles into research design and evaluation, particularly in protracted crises and recovery settings where resilient systems must integrate health and social care. REGISTRATION: Open Science Framework: https://doi.org/10.17605/OSF.IO/3A8CZ.