Developing a spinal cord injury research strategy using a structured process of evidence review and stakeholder dialogue. Part II: Background to a research strategy

Bragge, Peter; Piccenna, Loretta; Middleton, James; Williams, Steve; Creasey, Graham; Dunlop, Sarah; Brown, Douglas J.; Gruen, Russell L.

doi:10.1038/sc.2015.86

Cited by 15 publications

(33 citation statements)

References 30 publications

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“…Specifically, the findings of this rapid review were used to inform subsequent steps in the development of a regional SCI research strategy, as described in two companion papers. 60,61 Synthesis of the findings from these reviews is challenging, as they were conducted on separate bodies of literature, using different research paradigms. The reviews had to be evaluated with separate quality appraisal tools for quantitative and qualitative research synthesis (Appendix 2), meaning that a direct comparison of the results of quality appraisal is not possible.…”

Section: Discussionmentioning

confidence: 99%

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Developing a spinal cord injury research strategy using a structured process of evidence review and stakeholder dialogue. Part I: rapid review of SCI prioritisation literature

et al. 2015

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Study design: This is a rapid evidence review. Objectives: The objective of this study was to gain an overview of the volume, nature and findings of studies regarding priorities for spinal cord injury (SCI) research. Setting: A worldwide literature search was conducted. Methods: Six medical literature databases and Google Scholar were searched for reviews in which the primary aim was to identify SCI research priorities. Results: Two systematic reviews were identified-one of quantitative and one of qualitative studies. The quality of the reviews was variable. Collectively, the reviews identified 31 primary studies; 24 quantitative studies totalling 5262 participants and 7 qualitative studies totalling 120 participants. Despite the difference in research paradigms, there was convergence in review findings in the areas of body impairments and relationships. The vast majority of literature within the reviews focused on the SCI patient perspective. Conclusion: The reviews inform specific research topics and highlight other important research considerations, most notably those pertaining to SCI patients' perspectives on quality of life, which may be of use in determining meaningful research outcome measures. The views of other SCI research stakeholders such as researchers, clinicians, policymakers, funders and carers would help shape a bigger picture of SCI research priorities, ultimately optimising research outputs and translation into clinical practice and health policy change. Review findings informed subsequent activities in developing a regional SCI research strategy, as described in two companion papers. INTRODUCTIONSpinal cord injury (SCI) affects many individuals across the world. The annual incidence of traumatic SCI is estimated to range between 12.1 and 57.8 per million worldwide, 1 and SCI rates vary between countries and across regions-in North America (39 per million), Western Europe (16 per million), Australia (15 per million) and in New Zealand (30-49 per million). 2,3 In Australia, this equates to around 285 new acute traumatic SCIs per year, predominantly from transportrelated accidents (46%) and falls (28%), with tetraplegia (53%) slightly more frequent than paraplegia and the majority of cases involving males, with a male to female injury ratio of 5.3:1. 4 Non-traumatic SCI adds to these figures; an Australian study reported an age-adjusted adult incidence rate of 26.3 cases per million per year. 5 SCI prevalence is estimated to be 10-12 000 traumatic and 8000 non-traumatic cases in Australia. 6,7 Sensorimotor and autonomic nervous system dysfunction following SCI results in a range of acute, rehabilitation and long-term healthcare challenges, including pressure injuries, disorders of muscle tone and bowel and bladder problems. 8 These sequelae have long-term effects on independence and psychological well-being post SCI. 9 Aside from the potentially devastating impact of traumatic SCI on physical function, social participation and quality of life, traumatic SCI carries a high financial cost, esti...

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Section: Discussionmentioning

confidence: 99%

“…This work is described in two companion papers to this review-one outlining the background materials and methods 60 and one presenting the results of a day-long stakeholder dialogue that deliberated upon these issues. 61 'QOL was found to be diminished by problems associated with the impaired body; and by a sense of loss.…”

Section: Exclusion Criteriamentioning

confidence: 99%

Developing a spinal cord injury research strategy using a structured process of evidence review and stakeholder dialogue. Part I: rapid review of SCI prioritisation literature

et al. 2015

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“…Participants were identified and recruited using qualitative research principles; that is, purposefully sampled based on their specific knowledge or experience of the phenomenon of interest. 8 Specifically, potential stakeholder dialogue participants were identified and invited if they represented a stakeholder group of relevance to the development of a SCI research strategy (that is, clinician, researcher, funder, service provider, advocate) at a senior/ leadership level. Of the participants, 11 were from Victoria, 11 were from other Australian States and Territories, and 3 were from outside of Australia, with one representative from New Zealand and the other two overseas participants being high-profile, internationally recognised leaders in the field bringing expertise in SCI research and advocacy.…”

Section: Participantsmentioning

confidence: 99%

“…The primary output of the dialogue was a set of three overarching aims and three objectives of an Australian and New Zealand SCI Research Strategy. These are summarised in Table 1, which demonstrates how the draft principles developed and pre-circulated to dialogue participants 8 were modified to create the objectives of the strategy. Each objective is then described in detail based upon dialogue deliberations and resulting qualitative thematic analysis.…”

Section: Outputsmentioning

confidence: 99%

“…7 Developed a briefing document that synthesised research evidence and expert one-on-one consultations to create a SCI research strategy 'roadmap,' framework, draft principles and options for deliberation. 8 This paper describes the outcomes of phase two of the Forum-a day-long structured stakeholder dialogue based upon the briefing document-and discusses these in the context of local and international developments.…”

Section: Introductionmentioning

confidence: 99%

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Developing a spinal cord injury research strategy using a structured process of evidence review and stakeholder dialogue. Part III: outcomes

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Study design: Focus Group. Objectives: To develop a unified, regional spinal cord injury (SCI) research strategy for Australia and New Zealand. Setting: Australia. Methods: A 1-day structured stakeholder dialogue was convened in 2013 in Melbourne, Australia, by the National Trauma Research Institute in collaboration with the SCI Network of Australia and New Zealand. Twenty-three experts participated, representing local and international research, clinical, consumer, advocacy, government policy and funding perspectives. Preparatory work synthesised evidence and articulated draft principles and options as a starting point for discussion. Results: A regional SCI research strategy was proposed, whose objectives can be summarised under four themes. (1) Collaborative networks and strategic partnerships to increase efficiency, reduce duplication, build capacity and optimise research funding. (2) Research priority setting and coordination to manage competing studies. (3) Mechanisms for greater consumer engagement in research. (4) Resources and infrastructure to further develop SCI data registries, evaluate research translation and assess alignment of research strategy with stakeholder interests. These are consistent with contemporary international SCI research strategy development activities. Conclusion: This first step in a regional SCI research strategy has articulated objectives for further development by the wider SCI research community. The initiative has also reinforced the importance of coordinated, collective action in optimising outcomes following SCI.

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Neuron specific enolase: a promising therapeutic target in acute spinal cord injury

et al. 2016

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Enolase is a multifunctional protein, which is expressed abundantly in the cytosol. Upon stimulatory signals, enolase can traffic to cell surface and contribute to different pathologies including injury, autoimmunity, infection, inflammation, and cancer. Cell-surface expression of enolase is often detected on activated monocytes/macrophages, microglia and astrocytes, promoting extracellular matrix degradation, production of pro-inflammatory cytokines/chemokines, and invasion of inflammatory cells in the sites of injury and inflammation. Inflammatory stimulation also induces translocation of enolase from the cytosolic pool to the cell surface where it can act as a plasminogen receptor and promotes extracellular matrix degradation and tissue damage. Spinal cord injury (SCI) is a devastating debilitating condition whose progressive pathological changes include complex and evolving molecular cascades, and insights into the role of enolase in multiple inflammatory events have not yet been fully elucidated. Neuronal damage following SCI could be characterized by an elevation of neuron specific enolase (NSE), which is also known to play a role in the pathogenesis of hypoxic-ischemic brain injury. Thus, NSE is now considered as a biomarker in ischemic brain damage, and it has recently been suggested to be a biomarker in traumatic brain injury (TBI), stroke and anoxic encephalopathy after cardiac arrest and acute SCI as well. This review gives an overview of current basic research and clinical studies on the role of multifunctional enolase in neurotrauma, with a special emphasis on NSE in acute SCI.

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Developing a spinal cord injury research strategy using a structured process of evidence review and stakeholder dialogue. Part II: Background to a research strategy

Abstract: This project was funded by the Victorian Transport Accident Commission and the Australian and New Zealand Spinal Cord Injury Network.

Cited by 15 publications

References 30 publications

Developing a spinal cord injury research strategy using a structured process of evidence review and stakeholder dialogue. Part I: rapid review of SCI prioritisation literature

Developing a spinal cord injury research strategy using a structured process of evidence review and stakeholder dialogue. Part I: rapid review of SCI prioritisation literature

Developing a spinal cord injury research strategy using a structured process of evidence review and stakeholder dialogue. Part III: outcomes

Neuron specific enolase: a promising therapeutic target in acute spinal cord injury

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