When reporting differences in the incidence or proportion of a binary outcome between groups, common measures include absolute risk difference, relative risk (RR), and odds ratio (OR). For studies in which the primary outcome is a difference in proportions between two groups, Prehospital and Disaster Medicine prioritizes the absolute risk difference as the principal measure of effect, accompanied by a 95% confidence interval and P-value. Relative risk may be reported secondarily when appropriate. Odds ratios should generally be avoided as they are frequently misinterpreted and may exaggerate the apparent magnitude of an effect. Odds ratios should be limited to situations in which they are required by the selected statistical method.

Standard Community Assessment for Public Health Emergency Response (CASPER) methods, a type of rapid needs assessment (RNA) for collecting data on household needs and impacts following emergencies, are not always suitable for rural, destroyed, or severely damaged communities, or disasters affecting small geographical areas. The objectives of this modified RNA were to: (1) identify the strengths, limitations, and operational challenges for utilization of modified RNAs for post-disaster, quick response research; and (2) capture the acute mental and physical health impacts and lived experiences of communities affected by the 2024 Arbor Day tornado in Nebraska (USA). This field study tested modifications of the CASPER methodology in rural and inaccessible communities in Washington and Douglas County, Nebraska following the 2024 Arbor Day tornado. A 60-item survey was developed using validated questions, including on mental and physical health impacts. Survey completion rates for Washington and Douglas Counties were 57.3% and 89.3%, respectively. Exacerbation of existing conditions, worsening allergies, and stress were commonly reported following the tornado. Modified RNAs were useful and feasible approaches for capturing perishable data following the 2024 Arbor Day tornado outbreak. These findings can be used to inform not only public health response but also future planning and policy.

Peer review is an important step in supporting high-quality research publications. However, understanding the review process can be challenging for peer reviewers. The role of the peer reviewer varies from journal-to-journal. Furthermore, it is sometimes difficult for reviewers to understand how to structure and format their review. This article discusses the role of peer review in the Prehospital and Disaster Medicine (PDM) review process and provides guidance for creating a high-quality peer review report.

Rural communities face unique challenges after a disaster as a result of overlapping vulnerabilities related to limited housing and transportation infrastructure, employment or income loss, and fewer emergency response and recovery resources. Hurricane Helene (Southeast Coast, USA; 2024) made landfall in Florida as a Category-4 hurricane, later impacting Western North Carolina with severe flooding, landslides, and hurricane-force winds. Communications and transportation were interrupted for months, leading to disinformation, recovery disruptions, and a loss of trust. To assess household impacts and recovery from Hurricane Helene in two rural Western North Carolina counties, a 29-question survey was adapted from a Community Assessment for Public Health Emergency Response (CASPER) conducted in Buncombe County, a nearby urban county. Thirty clusters were selected with probability proportionate to population across the two counties. Survey teams completed 183 interviews (completion rate = 87.1%). More than 35% of households evacuated because of Hurricane Helene, with nearly 18% evacuating in the week after due to on-going communication and utility outages. Less than 10% of households experienced new or worsening environmental health or chronic diseases. However, 40% reported anxiety, 30% reported trouble sleeping and depression, and 60% reported worrying about another disaster affecting their home. Nearly one year after the direct impact of the hurricane, much work remained as part of continued long-term recovery and resilience building. Because of their small populations and limited infrastructure, restoration of services necessary for response and recovery can be hindered in rural areas which often lack options such as public transportation, affordable short-term housing, and broadband or Wi-Fi.

A chemical explosion and fire erupted in Conakry, Guinea, West Africa on December 18, 2023, destroying Guinea's main fuel depot and resulting in 25 dead and 459 injured. Fifteen of the deaths occurred directly at the explosion site. Firefighters initiated efforts to control the blaze and transported injured, non-ambulatory victims to local hospitals with assistance from the military, Red Cross, and mining companies. Thirteen clinical facilities within an eight-mile radius of the explosion received burn and non-burn victims, with only one of these, Donka National Hospital, capable of handling burn victims. Many less seriously injured victims self-selected where they sought care, although anecdotal information indicates that an unknown number of injured did not seek care or chose to leave the city. The disaster marked the first time stakeholders from various sectors in the Guinean society (from first responders to mining companies) came together in a concerted response. Ranked 179th of 193 countries on the Human Development Index (HDI), the disaster rapidly outstripped Guinea's response and health care capabilities, leaving behind economic shocks affecting livelihoods and the local economy. These experiences underscore the need for improved capabilities and coordination in disaster planning, warning and communication systems, and prehospital and hospital response in developing countries.

Unfortunately, P value multiplicity continues to be a pervasive threat to statistical validity in medical research. Performing many hypothesis tests, and treating them each as if they were a single hypothesis, leads to a dramatic increase in the risk of false research claims. This editorial describes a simple method for authors to avoid P value multiplicity while improving clarity of the findings for the reader.