Levels of evidence-based medicine in mass gathering public health and emergency medicine literature review

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In brief

Mass gathering science is a very new and emerging area, and it is now necessary to summarise the rigour of knowledge collected regarding the intricate interrelationships between significant event aspects, spectator profiles, and health concerns. This study aims to describe the levels of evidence found in peer-reviewed academic papers about mass collecting public health and emergency medicine. The data supporting the science of public health and evidence-based medicine practice has not been rigorously examined until now.


Several principal literature evaluations on various elements of mass collecting evidence-based medicine in research have been conducted in the past. They released a paper at the time that examined the level of scientific knowledge and urged scholars to address critical concerns in the provision of good healthcare during a large-scale meeting. In effect, throughout five years, the took stock of development in this specific area of mass gatherings.

Mass gathering science is a very new and emerging area. Therefore, it is necessary to summarise the depth of knowledge collected regarding the intricate interrelationships between key event features, patient profiles, and public health consequences. This study aims to conduct an online review of peer-reviewed scientific literature published between 2001 and 2011 about mass collecting public health and emergency medicine. The publications in this study are organized into specified World Health Organization (WHO) categories, and the degrees of evidence-based practice quantitative research is measured using the effectiveness classifications devised. The WHO categories are section titles that have been provisionally defined to reconstruct the WHO Guidelines for Mass Gathering Health. This helps comprehend the evolution of mass collecting literature since it offers information on the degree of evidence in publications.


The following online databases were searched: GALE, NLM, Web of Science, Elsevier, Wiley, BMJ Journals, OUP, IngentaConnect, RMIT, DOAJ, and JSTOR. Grey literature and published news stories were removed. The levels of evidence were examined using the effectiveness classifications generated after the peer-reviewed publications were organized into pre-determined World Health Organization categories. Then, using Microsoft Excel®, a descriptive statistical analysis was performed.

The articles were gathered into their subject matter category, as resolute by the WHO. The types comprised of:

1. Epidemiology

2. Event Operations

3. Disease Surveillance and Outbreak Response

4. Point of Entry Health

5. Psychosocial Considerations

6. Public Information and Health Promotion

7. Emergency Medical Services

8. Environmental Deliberations

In addition, each publication was categorized using the JBI stages of evidence about the effectiveness as follows:

  1. Meta-analysis of experimental trials (with homogeneity) (e.g., RCT with hidden randomization) OR A significant number of experimental trials with small confidence intervals
  2. one or smaller RCTs with broader confidence intervals Studies using a quasi-experimental design (without randomization)
    1. Cohort studies (including a control group), b) Case-controlled studies, and c) Observational studies (without control group)
  3. Consensus, expert opinion, or physiological bench research


Although high-level evidence studies may not be practicable in the setting of a mass gathering, investigations at the intermediate level should be promoted, so event management techniques are less reliant on experience and expert opinion. To construct a substantial body of knowledge, it is still necessary to carefully focus and further improve research in certain areas of mass collecting science. This prevalence of lower evidence-based practice literature review levels in the literature does not indicate that these research are uninformative or unusable in practice. The creation of theoretical models supported by more significant levels of evidence and capable of underlying preventative and response strategies that are successful and suited for implementation across diverse event types in varying situations and geographies may remain the focus of mass gathering research. Identifying the most significant levels of evidence in each mass collecting health area will be critical to creating theory. A counterpart to this demand is the need for increased research effort, particularly in disciplines where the volume and quality of research are woefully lacking.


The development of theoretical models supported by more significant levels of evidence is required to underlie the creation of effective preventative and response models that can be used in various types and situations of mass gatherings. Some areas of mass information collection are still underdeveloped and require much work.

About Pubrica

Pubrica has worked as a medical writer in the past. Clinical Research, Pharmacology, Public Health, Regulatory Writing, Clinical Report Forms (Crf), Biostatistics, Psychology, Life Science, Dentistry, Radiology, Dermatology, Diabetology, Gynecology, Cardiology, Biochemistry, Forensics, Surgery, Neurology, Psychiatry, Genomics, Medical Device, Pharmaceutical, Nutraceutical, Fmcg Companies, Hospitals, Universities, Publish Unique Medical Writing Services


  1. Arbon, Paul, Lynette Cusack, and Naomi Oenol. “Mass gathering public health and emergency medicine literature review: levels of evidence.” Australasian Journal of Paramedicine 10.1 (2013).

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