Title

NIH roundtable on emergency trauma research

Authors

Charles B. Cairns, The University of North Carolina at Chapel Hill
Ronald V. Maier, Harborview Medical Center
Opeolu Adeoye, University of Cincinnati
Darryl Baptiste, Toronto Western Hospital
William G. Barsan, University of Michigan, Ann Arbor
Lorne Blackbourne, United States Army
Randall Burd, Children's National Medical Center
Christopher Carpenter, University of Washington, Seattle
David Chang, Johns Hopkins University
William Cioffi, Rhode Island Hospital
Edward Cornwell, Howard University
J. Michael Dean, The University of Utah
Carmel Dyer, University of Texas System
David Jaffe, University of Washington, Seattle
Geoff Manley, University of California, San Francisco
William J. Meurer, University of Michigan, Ann Arbor
Robert Neumar, University of Pennsylvania
Robert Silbergleit, University of Michigan, Ann Arbor
Molly Stevens, Medical College of Wisconsin
Michael Wang, University of Miami
Debra Weiner, Children's Hospital Boston
David Wright, Emory University
Robin Conwit, National Institute of Neurological Disorders and Stroke (NINDS)
Billy Dunn, Food and Drug Administration
Basel Eldadah, National Institute of Aging
Debra Egan, National Heart
Rosemarie Filart, National Center for Research Resources (NCRR)
Giovanna Guerrero, National Institute of Neurological Disorders and Stroke (NINDS)
Dallas Hack
Michael Handigan, Emergency Care Coordinating Center
David Heppel, Health Resources and Services Administration
Richard Hunt, Centers for Disease Control and Prevention
Ramona Hicks, National Institute of Neurological Disorders and Stroke (NINDS)

Document Type

Journal Article

Publication Date

11-1-2010

Journal

Annals of Emergency Medicine

Volume

56

Issue

5

DOI

10.1016/j.annemergmed.2010.05.029

Abstract

Study objective: The National Institutes of Health (NIH) formed an NIH Task Force on Research in Emergency Medicine to enhance NIH support for emergency care research. The NIH Trauma Research Roundtable was convened on June 22 to 23, 2009. The objectives of the roundtable are to identify key research questions essential to advancing the scientific underpinnings of emergency trauma care and to discuss the barriers and best means to advance research by exploring the role of trauma research networks and collaboration between NIH and the emergency trauma care community. Methods: Before the roundtable, the emergency care domains to be discussed were selected and experts in each of the fields were invited to participate in the roundtable. Domain experts were asked to identify research priorities and challenges and separate them into mechanistic, translational, and clinical categories. During and after the conference, the lists were circulated among the participants and revised to reach a consensus. Results: Emergency trauma care research is characterized by focus on the timing, sequence, and time sensitivity of disease processes and treatment effects. Rapidly identifying the phenotype of patients on the time spectrum of acuity and severity after injury and the mechanistic reasons for heterogeneity in outcome are important challenges in emergency trauma research. Other research priorities include the need to elucidate the timing, sequence, and duration of causal molecular and cellular events involved in time-critical injuries, and the development of treatments capable of halting or reversing them; the need for novel experimental models of acute injury; the need to assess the effect of development and aging on the postinjury response; and the need to understand why there are regional differences in outcomes after injury. Important barriers to emergency care research include a limited number of trained investigators and experienced mentors, limited research infrastructure and support, and regulatory hurdles. Conclusion: The science of emergency trauma care may be advanced by facilitating the following: (1) development of an acute injury template for clinical research; (2) developing emergency trauma clinical research networks; (3) integrating emergency trauma research into Clinical and Translational Science Awards; (4) developing emergency carespecific initiatives within the existing structure of NIH institutes and centers; (5) involving acute trauma and emergency specialists in grant review and research advisory processes; (6) supporting learn-phase or small, clinical trials; (7) performing research to address ethical and regulatory issues; and (8) training emergency care investigators with research training programs. © 2010 American College of Emergency Physicians.

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