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Invited Commentary
March 27, 2019

Hard-earned Lifesaving Lessons From the Combat Zone

Author Affiliations
  • 1Center for Sustainment of Trauma and Readiness Skills–Cincinnati, US Air Force School for Aerospace Medicine, Wright-Patterson Air Force Base, Dayton, Ohio
  • 2Section of General Surgery, Department of Surgery, University of Cincinnati, Cincinnati, Ohio
JAMA Surg. 2019;154(7):609. doi:10.1001/jamasurg.2019.0152

Advancements in combat casualty care have resulted in substantial improvements in civilian and military trauma care across the past decade. Within the theater of war, the Joint Trauma System has proven extraordinarily effective at continually implementing changes to improve both prehospital and in-hospital care for wounded warriors. An important challenge of continuous quality improvement is that it can be difficult to determine the effectiveness of individual interventions when additional system-level changes are occurring during the same period. In this issue of JAMA Surgery, Howard and colleagues1 have used data from several Department of Defense databases to tackle this challenge, and their work should be commended.

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