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Management of the Injured Patient: Identification of Research Topics for Systematic Review Using the Delphi Technique

Nathens, Avery B. MD, PhD, MPH; Rivara, Frederick P. MD, MPH; Jurkovich, Gregory J. MD; Maier, Ronald V. MD; Johansen, Jennifer M.; Thompson, Diane C. MS

The Journal of Trauma: Injury, Infection, and Critical Care: March 2003 - Volume 54 - Issue 3 - p 595-601
doi: 10.1097/01.TA.0000028044.43091.74

Background  Systematic reviews of controlled clinical trials in the form of meta-analyses can serve as an important guide to direct clinical practice. This study identifies the most important research questions pertaining to the acute care of the injured patient using a Web-based Delphi technique to achieve consensus of expert opinion.

Methods  Experts in trauma care from the United States and Canada (n = 68) were asked to generate structured research questions and were then required to rank these questions in order of importance and estimate the amount of research currently published.

Results  The questions ranking in the highest tertile are presented along with an estimate of their importance and the amount of research published using an ordinal scale. Only 9 of 16 (56%) questions had some or a substantial amount of research available on which to perform a systematic review.

Conclusion  This study identifies the areas of trauma care in which research efforts might best be directed. In the absence of sufficient data for systematic reviews, these research topics represent important areas for the design and implementation of clinical trials.

From the Departments of Surgery (A.B.N., G.J.J., R.V.M.) and Pediatrics (F.P.R., J.M.J., D.C.T.), Harborview Injury Prevention and Research Center, University of Washington, Seattle, Washington.

Submitted for publication December 29, 2001.

Accepted for publication June 13, 2002.

Supported by grant R49/CCR002570 from the Centers for Disease Control and Prevention.

Address for reprints: Avery B. Nathens, MD, Division of Trauma and General Surgery, Harborview Medical Center, Box 359796, 325 9th Avenue, Seattle, WA 98104; email:

© 2003 Lippincott Williams & Wilkins, Inc.