One of the primary limitations of this project was the paucity of EMS databases. We had no nationally representative data sources which contained information regarding the frequency and nature of prehospital care in our country. The EMS Data Systems database was not a probability based nationally representative sample. However, we think it provides us with a reasonable estimate of the frequency and nature of EMS care in our country and do not think that use of a true probability based national sample would substantially change our project's findings. Another limitation was the lack of prehospital studies that addressed methodological issues pertaining to risk adjustment and outcome measurement of the priority conditions that were identified. Therefore, as stated in previous sections of this report, often the best we could do was make recommendations regarding the most promising measures that need to be evaluated for feasibility in the prehospital setting. However, we think we have provided an invaluable service to those wanting to evaluate prehospital care in that they now have some idea of what measures hold the greatest promise. Our study did not actually conduct any outcomes research. We cannot comment on what interventions for our priority conditions are effective. However, from the start, this was never the intention of the EMSOP project.
Our mission was to develop a "blueprint" and a "toolbox" for EMS outcomes research. Our project did not specifically address interfacility transport, air-medical transport, and the treatment and non-transport of patients. However, we think that many of the measures we are recommending would be readily applicable to these situations and encourage researchers to evaluate the EMSOP recommended measures in these settings. Since our project focused on outcomes from acute prehospital emrgency care we did not consider measures relevant to EMS injury/disease prevention activities. Nonetheless, we think effectiveness research regarding prevention services delivered by prehospital care providers is an important research area. We were unable to identify and recommend any condition-specific risk adjustment or Outcome measures for Respiratory Distress/Airway Obstruction and Pediatric Seizures. Prehospital researchers interested in these areas may need to conduct hospital-based evaluations to develop and validate appropriate condition specific measures that can then be evaluated in the prehospital setting.