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Food is locally sourced, abstracts have been submitted online, delegates are encouraged to travel to the conference by train or to car share, and we have asked sponsors to refrain from bringing large numbers of glossy brochures with them.

MRC CRASH is a randomised controlled trial (ISRCTN74459797) of the effect of corticosteroids on death and disability after head injury. We randomly allocated 10 008 adults with head injury and a Glasgow Coma Scale score of 14 or less, within 8 h of injury, to a 48-h infusion of corticosteroid (methylprednisolone) or placebo. Data at 6 months were obtained for 9673 (96·7%) patients. The risk of death was higher in the corticosteroid group than in the placebo group (1248 [25·7%] vs 1075 [22·3%] deaths; relative risk 1·15, 95% CI 1·07–1·24; p=0·0001), as was the risk of death or severe disability (1828 [38·1%] vs 1728 [36·3%] dead or severely disabled; 1·05, 0·99–1·10; p=0·079). There was no evidence that the effect of corticosteroids differed by injury severity or time since injury. These results lend support to our earlier conclusion that corticosteroids should not be used routinely in the treatment of head injury.

[...]this solution to the problem is simplistic and fraught with risk, including to our staff and to us.