Research and conflict: mapping research trends and gaps in Ukrainian Emergency Medical Services- a scoping review.

Introduction: Conflict´s impact on research has seldom been analyzed, while research activities may improve population health and health service provision in conflicts. Efficient functioning of Emergency Medical Services (EMS) is essential for providing regular emergency care and addressing the healthcare needs arising from the ongoing conflict in Ukraine. However, research on the development, challenges, and opportunities of EMS system are limited. The objective of this review was to document the research trends, identify how conflict has shaped research production, and knowledge gaps related to EMS in Ukraine from 2002 to 2024.

Methods: A systematic literature search was conducted on January 26, 2025, on PubMed, Scopus, and Web of Science, following the PRISMA-ScR guidelines. The review included peer-reviewed studies, commentaries, case studies, reports, and policy documents focusing on EMS in Ukraine. Data extraction and analysis were performed using Microsoft Excel (Version 2501) and Jupyter Notebook(running on Jupyter Server 2.15.0) with visualization using Sankey plots and heatmaps.

Results: Of the 1,010 initially identified articles, 62 met the inclusion criteria. Research topics have evolved significantly, with Disease-Specific Care in conflict emerging as an extensively studied area (n = 8) post-2022. Quality of Care (n = 12) and Hospital Care (n = 7) were prominent focus areas. Profound impact on EMS research activity was noted in the 2022 invasion in comparison to the 2014 conflict, causing widespread service disruptions (n = 15) and a positive impact on the evolution of EMS training (n = 11). Key research gaps included lack of data, standardized protocols, and resource limitations within the emergency management system.

Conclusions: This review highlights the evolving field of EMS research in Ukraine, emphasizing the growing focus on specialized care in conflict environments. The findings underscore both the resilience of Ukraine's EMS system and the need to establish standardized data collection systems, develop cost-effective resource management strategies, improve coordination among key stakeholders, and explore innovative technologies to enhance EMS operations in crisis situations.