Position statement of the Coalition for National Trauma Research on the National Academies of Sciences, Engineering and Medicine report, A National Trauma Care System

Jenkins, Donald H.; Cioffi, William G.; Cocanour, Christine S.; Davis, Kimberly A.; Fabian, Timothy C.; Jurkovich, Gregory J.; Rozycki, Grace S.; Scalea, Thomas M.; Stassen, Nicole A.; Stewart, Ronald M.

doi:10.1097/ta.0000000000001218

Cited by 23 publications

(10 citation statements)

References 4 publications

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“…Questions from Round 0 were compiled by the investigator team and loaded into Surveylet for Round 1, during which participants were asked to rate the priority of each research question on a 9-point Likert scale (1, low priority; 9, high priority). In Rounds 2 and 3, participants received numerical and graphical feedback based on the aggregated responses of other survey participants and could change their ratings in an effort to reach consensus regarding each question's priority as low, 1–3 medium, 4–6 or high 7–9 . Questions that reached consensus, defined as 60% agreement, were removed from subsequent rounds.…”

Section: Internet-based Delphi Methodologymentioning

confidence: 99%

Developing a National Trauma Research Action Plan: Results from the Pediatric Research Gap Delphi Survey

Groner

Phuong²,

Price³

et al. 2022

J Trauma Acute Care Surg

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BACKGROUND:In 2016, the National Academies of Sciences, Engineering, and Medicine trauma report recommended a National Trauma Research Action Plan to "strengthen trauma research and ensure that the resources available for this research are commensurate with the importance of injury and the potential for improvement in patient outcomes." With a contract from the Department of Defense, the Coalition for National Trauma Research created 11 expert panels to address this recommendation, with the goal of developing a comprehensive research agenda, spanning the continuum of trauma and burn care. This report outlines the work of the group focused on pediatric trauma. METHODS:Experts in pediatric trauma clinical care and research were recruited to identify gaps in current clinical pediatric trauma research, generate research questions, and establish the priority of these questions using a consensus-driven Delphi survey approach. Using successive surveys, participants were asked to rank the priority of each research question on a 9-point Likert scale categorized to represent priority. Consensus was defined as >60% agreement within the priority category. Priority questions were coded based on a dictionary of 118 National Trauma Research Action Plan taxonomy concepts in 9 categories to support comparative analysis across all panels. RESULTS:Thirty-seven subject matter experts generated 625 questions. A total of 493 questions (79%) reached consensus on priority level. Of those reaching consensus, 159 (32%) were high, 325 (66%) were medium, and 9 (2%) were low priority. The highest priority research questions related to surgical interventions for traumatic brain injury (intracranial pressure monitoring and craniotomy); the second highest priority was hemorrhagic shock. The prehospital setting was the highest priority phase of care. CONCLUSION:This diverse panel of experts determined that most significant pediatric trauma research gaps were in traumatic brain injury, hemorrhagic shock, and the prehospital phase of care. These research domains should be top priorities for funding agencies.

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Section: Internet-based Delphi Methodologymentioning

confidence: 99%

Developing a National Trauma Research Action Plan: Results from the Pediatric Research Gap Delphi Survey

Groner

Phuong²,

Price³

et al. 2022

J Trauma Acute Care Surg

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“…In June 2016, the National Academies of Sciences, Engineering, and Medicine (NASEM) released the report entitled A National Trauma Care System: Integrating Military and Civilian Trauma Systems to Achieve Zero Preventable Deaths After Injury [29], with 11 recommendations to reach the goal. The Coalition for National Trauma Research (CNTR) publicly supported this report in their position statement released in August 2016, which emphasized recommendations 7 and 8:…”

Section: Reflections and Future Endeavorsmentioning

confidence: 99%

“…"To strengthen trauma research and ensure that the resources available for this research are commensurate with the importance of injury and the potential for improvement in patient outcomes, the White House should issue an executive order mandating the Armed with these NASEM recommendations in addition to the valuable research experience of the organization, the CNTR "stands ready to lead to the national injury research initiative" (p818) [29]. As orthopedic surgeons, we can be agents of the change needed in trauma care.…”

Section: Reflections and Future Endeavorsmentioning

confidence: 99%

Accessibility, accountability, affordability: healthcare policy in orthopedic trauma

Genova

Box

Ficke

2017

Curr Rev Musculoskelet Med

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Purpose of review This review provides historical background on trauma care in the USA and summarizes contemporary trauma-related health policy issues. It is a primer for orthopedic surgeons who want to promote improvements in research, delivery, and cost reduction in trauma care. Recent findings As of 2010, funding for trauma research accounted for only 0.02% of all National Institutes of Health research funding. This is disproportionate to the societal burden of traumatic injury, which is the leading cause of death and disability among people aged 1 to 46 years in the USA. The diagnosis-related group model of hospital reimbursement penalizes level-I trauma centers, which typically treat the most severely injured patients. Treatment of traumatic injury at level-I and level-II trauma centers is associated with lower rates of major complications and death compared with treatment at non-trauma centers. Patient proximity to trauma centers has been positively correlated with survival after traumatic injury. Inadequate funding has been cited as a reason for recent closures of trauma centers. Summary Orthopedic surgeons have a responsibility to engage in efforts to improve the quality, accessibility, and affordability of trauma care. This can be done by advocating for greater funding for trauma research; choosing the most costeffective, patient-appropriate orthopedic implants; supporting the implementation of a national trauma system; leading highquality research of trauma patient outcomes; and advocating for greater accessibility to level-I trauma centers for underserved populations.

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“…The Coalition for National Trauma Research has advocated for trauma research funding, in part, through the development of research agendas to prioritize research gaps in both civilian and military settings. To advance previously published trauma research agendas and to include additional domains, the Coalition for National Trauma Research coordinated the development of NTRAP across the spectrum of injury care 6,8 . This project has engaged more than 400 multidisciplinary stakeholders participating in panels divided into 11 different focus areas to identify research gaps and high-priority research questions that should direct extramural research support in the future.…”

mentioning

confidence: 99%

Developing a National Trauma Research Action Plan: Results from the acute resuscitation, initial patient evaluation, imaging, and management research gap Delphi survey

Costantini¹,

Galante²,

Braverman³

et al. 2022

J Trauma Acute Care Surg

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BACKGROUND: Injury is the leading cause of death in patients aged 1 to 45 years and contributes to a significant public health burden for individuals of all ages. To achieve zero preventable deaths and disability after injury, the National Academies of Science, Engineering and Medicine called for the development of a National Trauma Research Action Plan to improve outcomes for military and civilian trauma patients. Because rapid resuscitation and prompt identification and treatment of injuries are critical in achieving optimal outcomes, a panel of experts was convened to generate high-priority research questions in the areas of acute resuscitation, initial evaluation, imaging, and definitive management on injury. METHODS:Forty-three subject matter experts in trauma care and injury research were recruited to perform a gap analysis of current literature and prioritize unanswered research questions using a consensus-driven Delphi survey approach. Four Delphi rounds were conducted to generate research questions and prioritize them using a 9-point Likert scale. Research questions were stratified as low, medium, or high priority, with consensus defined as ≥60% of panelists agreeing on the priority category. Research questions were coded using a taxonomy of 118 research concepts that were standard across all National Trauma Research Action Plan panels. RESULTS:There were 1,422 questions generated, of which 992 (69.8%) reached consensus. Of the questions reaching consensus, 327 (33.0%) were given high priority, 621 (62.6%) medium priority, and 44 (4.4%) low priority. Pharmaceutical intervention and fluid/blood product resuscitation were most frequently scored as high-priority intervention concepts. Research questions related to traumatic brain injury, vascular injury, pelvic fracture, and venous thromboembolism prophylaxis were highly prioritized. CONCLUSION: This research gap analysis identified more than 300 high-priority research questions within the broad category of Acute Resuscitation, Initial Evaluation, Imaging, and Definitive Management. Research funding should be prioritized to address these high-priority topics in the future. (J

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Position statement of the Coalition for National Trauma Research on the National Academies of Sciences, Engineering and Medicine report, A National Trauma Care System

Cited by 23 publications

References 4 publications

Developing a National Trauma Research Action Plan: Results from the Pediatric Research Gap Delphi Survey

Developing a National Trauma Research Action Plan: Results from the Pediatric Research Gap Delphi Survey

Accessibility, accountability, affordability: healthcare policy in orthopedic trauma

Developing a National Trauma Research Action Plan: Results from the acute resuscitation, initial patient evaluation, imaging, and management research gap Delphi survey

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