Views about pre-hospital REBOA: individual and collective equipoise (TDF beliefs about consequences; social influences)
SAID
Participants recognised the potential benefits associated with REBOA in the pre-hospital setting, but most noted the potential risks involved. There were mixed responses in relation to questions that explored equipoise and relatedly whether clinical participants would be happy to randomise patients to a pre-hospital trial of REBOA. Whilst some participants indicated that they would hesitate to randomise, many suggested that their inherent positive beliefs about REBOA (and lack of equipoise) meant that they would struggle to follow the randomisation outcome if the patient was allocated to standard care.Whilst I’ve said ultimately we don’t know whether our patient would have survived without us I think we’re going to have a group of patients who are literally therefore dying in front of us and maybe if we were in an RCT we wouldn’t have put a balloon in or we wouldn’t have inflated a balloon. Once you’ve gone down this road you could end up feeling that you’ve denied a patient some care that could have saved them. Consultant, participant 4.Relatedly, many participants highlighted the overall community equipoise, often noting the willingness to participate in a trial of pre-hospital REBOA to establish the effectiveness, which could influence personal and team decisions.There’s passionate people who are very pro and people who aren’t, but I suppose the thing is that the vast majority of clinicians who are involved in this also understand the importance to the population of these patients to answer this question. Consultant, participant 8.