From a question
What are the benefits and harms of Viscoelastic testing-guided clinical care (i.e., transfusion strategies) for patient important outcomes (e.g., mortality, bleeding events) as compared with transfusion guided by any other method in adult patients experiencing major trauma and blood loss?
DoneStarted Oct 28, 2026, 23:47 UTCFinished Oct 28, 2026, 23:48 UTC
Stages
- Finding the known studies(done)
- Drafting(done)
- Checking MeSH(done)
- Counting in PubMed(done)
- Checking known studies(done)
- Comparing with the reference(done)
- Run Search(done)
- Saving(done)
Run log (23)
- Finding the known studies: Finding 3 known studies in PubMed
- Note: With fewer than 6 known studies matched to PubMed records (3 matched), all are kept for validation and none is shown to the model.
- Drafting: Drafting concepts and terms
- Checking MeSH: Checking every MeSH heading, Supplementary Concept and publication type against NLM
- Counting in PubMed: Running 14 lines on PubMed
- Line 4: 6,734 records
- Line 1: 1,118,508 records
- Line 2: 1,588,009 records
- Line 5: 11,683 records
- Line 6: 2,114 records
- Line 7: 14,793 records
- Line 8: 2,117 records
- Line 9: 10,282,724 records
- Line 10: 1,622 records
- Line 11: 1,534 records
- Line 3: 2,195,865 records
- Line 13: 1,887,144 records
- Line 14: 2,319,897 records
- Line 12: 913,516 records
- Checking known studies: Checking which known studies the final query finds
- Run Search: Fetching the first 20 records
- Saving: Saving the run
- Finished.
Final count (line 11)
1,534
Query as run (991 characters)
(((("Wounds and Injuries"[Mesh] OR "Multiple Trauma"[Mesh] OR "Shock, Hemorrhagic"[Mesh] OR "Trauma Centers"[Mesh]) OR (trauma*[tiab] OR injur*[tiab] OR polytrauma*[tiab] OR casualt*[tiab] OR battlefield[tiab] OR wounded[tiab])) AND (("Thrombelastography"[Mesh]) OR (thromboelastogra*[tiab] OR thrombelastogra*[tiab] OR thromboelastometr*[tiab] OR thrombelastometr*[tiab] OR TEG[tiab] OR ROTEM[tiab] OR ClotPro[tiab] OR Quantra[tiab] OR Sonoclot[tiab] OR "viscoelastic test*"[tiab] OR "viscoelastic assay*"[tiab] OR "viscoelastic hemostat*"[tiab] OR "viscoelastic haemostat*"[tiab] OR "viscoelastic coagulation"[tiab] OR "viscoelastic guided"[tiab] OR "viscoelastic monitoring"[tiab] OR "viscoelastic method*"[tiab] OR "point-of-care coagulation"[tiab]) OR (viscoelastic[ot]))) NOT ("Editorial"[Publication Type] OR "Letter"[Publication Type] OR "Case Reports"[Publication Type] OR "Preprint"[Publication Type] OR "Comment"[Publication Type] OR (animals[mh] NOT humans[mh]))) AND english[la]Known studies
3 of 3 found
95% CI 29%–100%
Only studies the model never saw are counted. Finding known studies does not prove the search is complete.
Each study (3)
- Found: 10.1186/s13063-017-2224-9PMID 29047413 · held back for validation
- Found: 10.1007/s00134-020-06266-1PMID 33048195 · held back for validation
- Found: 10.1097/SLA.0000000000001608PMID 26720428 · held back for validation
Reference strategy
No reference strategy was given.
Search lines
| No. | Search | Results |
|---|---|---|
| 1 | Major trauma and traumatic blood loss "Wounds and Injuries"[Mesh] (MeSH heading valid: D014947) OR "Multiple Trauma"[Mesh] (MeSH heading valid: D009104) OR "Shock, Hemorrhagic"[Mesh] (MeSH heading valid: D012771) OR "Trauma Centers"[Mesh] (MeSH heading valid: D014193) | 1,118,508 |
| 2 | Major trauma and traumatic blood loss trauma*[tiab] OR injur*[tiab] OR polytrauma*[tiab] OR casualt*[tiab] OR battlefield[tiab] OR wounded[tiab] | 1,588,009 |
| 3 | Major trauma and traumatic blood loss · block 1 OR 2 | 2,195,865 |
| 4 | Viscoelastic haemostatic testing "Thrombelastography"[Mesh] (MeSH heading valid: D013916) | 6,734 |
| 5 | Viscoelastic haemostatic testing thromboelastogra*[tiab] OR thrombelastogra*[tiab] OR thromboelastometr*[tiab] OR thrombelastometr*[tiab] OR TEG[tiab] OR ROTEM[tiab] OR ClotPro[tiab] OR Quantra[tiab] OR Sonoclot[tiab] OR "viscoelastic test*"[tiab] OR "viscoelastic assay*"[tiab] OR "viscoelastic hemostat*"[tiab] OR "viscoelastic haemostat*"[tiab] OR "viscoelastic coagulation"[tiab] OR "viscoelastic guided"[tiab] OR "viscoelastic monitoring"[tiab] OR "viscoelastic method*"[tiab] OR "point-of-care coagulation"[tiab] | 11,683 |
| 6 | Viscoelastic haemostatic testing viscoelastic[ot] | 2,114 |
| 7 | Viscoelastic haemostatic testing · block 4 OR 5 OR 6 | 14,793 |
| 8 | combined 3 AND 7 | 2,117 |
| 9 | excluded "Editorial"[Publication Type] (publication type valid: D016421) OR "Letter"[Publication Type] (publication type valid: D016422) OR "Case Reports"[Publication Type] (publication type valid: D002363) OR "Preprint"[Publication Type] (publication type valid: D000076942) OR "Comment"[Publication Type] (publication type valid: D016420) OR (animals[mh] NOT humans[mh]) | 10,282,724 |
| 10 | exclusions removed 8 NOT 9 | 1,622 |
| 11Final | limits 10 AND english[la] | 1,534 |
| 12 | Transfusion, bleeding and mortality "Blood Transfusion"[Mesh] (MeSH heading valid: D001803) OR "Hemorrhage"[Mesh] (MeSH heading valid: D006470) OR "Mortality"[Mesh] (MeSH heading valid: D009026) | 913,516 |
| 13 | Transfusion, bleeding and mortality transfus*[tiab] OR hemorrhag*[tiab] OR haemorrhag*[tiab] OR bleeding[tiab] OR mortality[tiab] | 1,887,144 |
| 14 | Transfusion, bleeding and mortality · block 12 OR 13 | 2,319,897 |
Issues
- Warning: Language limit (english): it can remove relevant studies; report and justify it.
- Warning: Publication types excluded with NOT (Editorial, Letter, Case Reports, Preprint, Comment): report and justify the exclusion.
- Note: With fewer than 6 known studies matched to PubMed records (3 matched), all are kept for validation and none is shown to the model.
First records
- Viscoelastic Hemostatic Testing as a Diagnostic Tool for Trauma-Induced Coagulopathy with a Focus on Arabian Gulf Countries: A Narrative Review. (PubMed, opens in a new tab)
Yassen KA, Görlinger K, Alzimami L et al. · Journal of clinical medicine · 2026 · PMID 42941561
- Management of transfusion in traumatic hemorrhagic shock. (PubMed, opens in a new tab)
Werner M, Bergis B, Harrois A · Current opinion in critical care · 2026 · PMID 42932991
- Effects of rivaroxaban combined with clopidogrel on thrombotic risk and myocardial injury indicators in patients with coronary artery ectasia. (PubMed, opens in a new tab)
Geng T, Feng M, Wu Y et al. · Frontiers in cardiovascular medicine · 2026 · PMID 42920619
- Prognostic Value of Thromboelastography Parameters for Early Trauma-Induced Coagulopathy in Severely Injured Patients: A Retrospective Cohort Study. (PubMed, opens in a new tab)
Honnef G, Zoidl P, Hallmann B et al. · Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2026 · PMID 42902959
- Perioperative Myocardial Injury and Infarction: Thrombotic Mechanisms, Diagnostic Challenges, and Antithrombotic Management. (PubMed, opens in a new tab)
Jang JY, Bae JS, Cho YH et al. · Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis · 2026 · PMID 42858166
- Survival benefit of prehospital TXA in fibrinolytic shutdown: Insights from two prospective trauma trials. (PubMed, opens in a new tab)
Kenny JE, Brito AM, Benchiba-Charron M et al. · The journal of trauma and acute care surgery · 2026 · PMID 42853261
- Defining Rotational Thromboelastometry Thresholds for Fibrinolysis Phenotyping and Massive Transfusion Prediction in Trauma. (PubMed, opens in a new tab)
Meade R, Bowman SM, Jensen HK et al. · The Journal of surgical research · 2026 · PMID 42815292
- Methodological Approaches in the Evaluation of Platelet Structure and Function: An Instrumental Perspective. (PubMed, opens in a new tab)
Beura SK, Kulkarni PP, Singh SK · Journal of thrombosis and thrombolysis · 2026 · PMID 42801447
- Treatment of Antithrombotic-Associated Intracranial Hemorrhage in Adults: A Focused Guideline Update from the Neurocritical Care Society and the Society of Critical Care Medicine. (PubMed, opens in a new tab)
Vallejo MC, Kennedy LS, Dengler B et al. · Neurocritical care · 2026 · PMID 42786382
- Rotational thromboelastometry-guided transfusion in acute trauma: Less plasma, greater precision. (PubMed, opens in a new tab)
Dinić R, Šabani A, Životić B et al. · Vox sanguinis · 2026 · PMID 42778196
- Viscoelastic hemostatic assays in trauma-induced coagulopathy: Precision transfusion, fibrinolytic phenotyping, and future directions. (PubMed, opens in a new tab)
Wu L, Ben J, Lu J · Microvascular research · 2026 · PMID 42762956
- Evaluation of Platelet Contribution to Clot Strength in Neonates with Perinatal Hypoxia Using Rotational Thromboelastometry. (PubMed, opens in a new tab)
Konstantinidi A, Sokou R, Tsantes AG et al. · Seminars in thrombosis and hemostasis · 2026 · PMID 42759550
- Challenges, Advances, and Contemporary Developments in Trauma Care in Emergency Departments: A Scoping Review. (PubMed, opens in a new tab)
Shahcheragh SH, Moonesan MR, Babamohamadi H · Journal of emergency nursing · 2026 · PMID 42758066
- A refined phenomenological model of viscoelastic clot formation and lysis in trauma-induced coagulopathy. (PubMed, opens in a new tab)
Liu G, Shick AE, Shamash M et al. · Frontiers in cardiovascular medicine · 2026 · PMID 42756045
- Gelatin 4% and hydroxyethyl starch (130/0.42) impair clot formation in a human ex vivo whole-blood resuscitation model. (PubMed, opens in a new tab)
Mannes M, Spiegelburg DT, Datzmann T et al. · Scandinavian journal of trauma, resuscitation and emergency medicine · 2026 · PMID 42750072
- Persistent postoperative hypercoagulability and venous thromboembolism risk following pelvic and acetabular fractures: A prospective pilot study. (PubMed, opens in a new tab)
Clarke A, Tera Y, Skeith L et al. · Injury · 2026 · PMID 42748774
- Quantitative assessment of viscoelastic skin properties in a porcine model: Implications for regenerative therapies. (PubMed, opens in a new tab)
Váňa V, Koudelková N, Lipový B et al. · Veterinary journal (London, England : 1997) · 2026 · PMID 42697363
- Trauma-Induced Coagulopathy: From Endotheliopathy and Fibrinolysis Phenotypes to Viscoelastic-Guided Resuscitation. (PubMed, opens in a new tab)
Meister R, Kim Y, Landry TC et al. · European journal of haematology · 2026 · PMID 42680516
- Aging at the Cellular Level: An Exploratory Analysis of the Effect of Age on Platelet Dynamics in Injured Patients. (PubMed, opens in a new tab)
Beattie G, Joseph BA, Nunez-Garcia B et al. · Shock (Augusta, Ga.) · 2026 · PMID 42678754
- Evaluation of changes in coagulation profile by thromboelastography in patients undergoing lobectomy for malignancy. (PubMed, opens in a new tab)
Keçeci Özgür G, Mammadov R, Akpunar E et al. · Turk gogus kalp damar cerrahisi dergisi · 2026 · PMID 42661399
Export
The strategy file has the numbered lines with counts, the search date and the AI-use statement. PMIDs and MEDLINE are fetched from PubMed when you download, so they reflect PubMed today.
Checking PubMed for the current list of PMIDs…
Objective and notes from the draft
To assess the benefits and harms of viscoelastic testing-guided care (such as transfusion strategies guided by thromboelastography or rotational thromboelastometry) compared with transfusion guided by any other method in adults with major trauma and blood loss, for patient-important outcomes such as mortality and bleeding events.
- The final query combines only the trauma and viscoelastic testing concepts; the outcome concept is provided as an optional block because outcomes such as mortality, bleeding and transfusion are often not reported in the title, abstract or indexing.
- No adult age filter is applied, because age is poorly indexed in trauma studies and adult-only filtering would risk losing relevant records; adult status should be checked at screening.
- No comparator concept is used, because comparators (conventional coagulation tests, fixed-ratio protocols, clinician judgement) are too varied to search reliably.
- The bare word viscoelastic is searched only as an author keyword; in the title and abstract it is combined with test, assay, haemostatic or coagulation words, to avoid biomechanics studies of viscoelastic tissue properties in injury.
- Blood Coagulation Tests was left out as a heading because it mainly retrieves conventional coagulation tests, which are the comparator rather than the intervention.
- Hemorrhage was not added to the trauma concept, so that viscoelastic-guided transfusion in cardiac surgery, liver transplantation and obstetrics is not retrieved.
Edit the strategy
Major trauma and traumatic blood lossPopulation
2,195,865 records · 10 of 10 terms on · 1 suggestion off
- MeSH valid: D014947AI
"Wounds and Injuries"[Mesh]
Main heading for trauma; exploded so that specific injury types (head, penetrating, blunt, multiple) are all included.
- MeSH valid: D009104AI
"Multiple Trauma"[Mesh]
Polytrauma is the typical population of major-trauma transfusion studies.
- MeSH valid: D012771AI
"Shock, Hemorrhagic"[Mesh]
Haemorrhagic shock captures the blood-loss component of the trauma population.
- MeSH valid: D014193AI
"Trauma Centers"[Mesh]
Studies set in trauma centres may be indexed by setting rather than by injury type.
- TextAI
trauma*[tiab]
Covers trauma, traumatic, trauma-induced coagulopathy and acute traumatic coagulopathy.
- TextAI
injur*[tiab]
Covers injury, injuries and injured, the usual author wording for the population.
- TextAI
polytrauma*[tiab]
Joined form for multiple trauma used by authors.
- TextAI
casualt*[tiab]
Military and mass-casualty studies describe patients as casualties.
- TextAI
battlefield[tiab]
Military trauma studies of viscoelastic-guided resuscitation.
- TextAI
wounded[tiab]
Alternative wording for injured patients, especially in combat settings.
Suggested MeSH entry terms (1, off)
- TextEntry term
"Hemorrhagic Shock"[tiab]
Synonym of the MeSH heading "Shock, Hemorrhagic" (D012771)
Viscoelastic haemostatic testingIntervention
14,793 records · 20 of 20 terms on
- MeSH valid: D013916AI
"Thrombelastography"[Mesh]
The MeSH heading for viscoelastic coagulation testing, including thromboelastometry.
- TextAI
thromboelastogra*[tiab]
Covers thromboelastography and thromboelastogram.
- TextAI
thrombelastogra*[tiab]
Alternative spelling used in MeSH and by some authors.
- TextAI
thromboelastometr*[tiab]
Covers thromboelastometry, including rotational thromboelastometry.
- TextAI
thrombelastometr*[tiab]
Alternative spelling of thromboelastometry.
- TextAI
TEG[tiab]
Common abbreviation for thromboelastography, including rapid TEG and TEG 6s.
- TextAI
ROTEM[tiab]
Common abbreviation and device name for rotational thromboelastometry.
- TextAI
ClotPro[tiab]
Newer viscoelastic device named in trauma studies.
- TextAI
Quantra[tiab]
Viscoelastic sonorheometry device named in trauma studies.
- TextAI
Sonoclot[tiab]
Older viscoelastic coagulation analyser.
- TextAI
"viscoelastic test*"[tiab]
Generic name for the intervention (test, tests, testing).
- TextAI
"viscoelastic assay*"[tiab]
Generic wording for viscoelastic methods.
- TextAI
"viscoelastic hemostat*"[tiab]
Covers viscoelastic hemostatic assays and testing (American spelling).
- TextAI
"viscoelastic haemostat*"[tiab]
Covers viscoelastic haemostatic assays and testing (British spelling).
- TextAI
"viscoelastic coagulation"[tiab]
Wording such as viscoelastic coagulation tests or monitoring.
- TextAI
"viscoelastic guided"[tiab]
Wording for viscoelastic-guided transfusion or resuscitation.
- TextAI
"viscoelastic monitoring"[tiab]
Alternative wording for viscoelastic point-of-care monitoring.
- TextAI
"viscoelastic method*"[tiab]
Alternative generic wording for viscoelastic techniques.
- TextAI
"point-of-care coagulation"[tiab]
Viscoelastic tests are often described as point-of-care coagulation testing.
- TextAI
viscoelastic[ot]
Author keyword for the intervention, limited to keywords to avoid biomechanics records.
Transfusion, bleeding and mortalityOutcome
2,319,897 records · 8 of 8 terms on · 5 suggestions off
- MeSH valid: D001803AI
"Blood Transfusion"[Mesh]
Transfusion strategy and requirements are the guided intervention and a key outcome.
- MeSH valid: D006470AI
"Hemorrhage"[Mesh]
Bleeding events are a named patient-important outcome.
- MeSH valid: D009026AI
"Mortality"[Mesh]
Mortality is a named patient-important outcome.
- TextAI
transfus*[tiab]
Covers transfusion, transfused and transfusions.
- TextAI
hemorrhag*[tiab]
Bleeding outcomes, American spelling.
- TextAI
haemorrhag*[tiab]
Bleeding outcomes, British spelling.
- TextAI
bleeding[tiab]
Common author wording for bleeding events.
- TextAI
mortality[tiab]
Primary patient-important outcome.
Suggested MeSH entry terms (5, off)
- TextEntry term
"Death Rate"[tiab]
Synonym of the MeSH heading "Mortality" (D009026)
- TextEntry term
"Crude Death Rate"[tiab]
Narrower concept under the MeSH heading "Mortality" (D009026)
- TextEntry term
"Case Fatality Rate"[tiab]
Narrower concept under the MeSH heading "Mortality" (D009026)
- TextEntry term
"Age-Specific Death Rate"[tiab]
Narrower concept under the MeSH heading "Mortality" (D009026)
- TextEntry term
"CFR Case Fatality Rate"[tiab]
Narrower concept "Case Fatality Rate" under the MeSH heading "Mortality" (D009026)
Limits
Publication types to exclude
Each one is checked against MeSH publication types before it is added.
- Editorial
- Letter
- Case Reports
- Preprint
- Comment
No changes.