Developing a National Trauma Research Action Plan: Results from the prehospital and mass casualty research Delphi survey : Journal of Trauma and Acute Care Surgery

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Developing a National Trauma Research Action Plan: Results from the prehospital and mass casualty research Delphi survey

Newgard, Craig D. MD, MPH; Braverman, Maxwell A. DO; Phuong, Jimmy PhD; Shipper, Edward S. MD; Price, Michelle A. PhD; Bixby, Pamela J. MA; Goralnick, Eric MD, MS; Daya, Mohamud R. MD, MSc; Lerner, E. Brooke PhD; Guyette, Francis X. MD, MPH; Rowell, Susan MD, MBA, MCR; Doucet, Jay MD, MSc; Jenkins, Peter MD, MS; Mann, N. Clay PhD, MS, MBA; Staudenmayer, Kristan MD, MS; Blake, David P. MD, MPH, DMCC; Bulger, Eileen MD, FACS

Author Information

From the Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine (C.D.N., M.R.D.), Oregon Health and Science University, Portland, Oregon; Coalition for National Trauma Research (M.A.B., E.S.S., M.A.P., P.J.B.), San Antonio, Texas; Department of Biomedical Informatics and Medical Education (J.P.), University of Washington, Seattle, Washington; Department of Emergency Medicine (E.G.), Brigham and Women's Hospital Harvard Medical School Boston, Massachusetts; Department of Emergency Medicine (E.B.L.), Jacobs School of Medicine and Biomedical Sciences University at Buffalo, Buffalo, New York; Department of Emergency Medicine (F.X.G.), University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Surgery (S.R.), University of Chicago Medicine and Biological Sciences, Chicago, Illinois; Division of Trauma, Surgical Critical Care, Burns and Acute Care Surgery, Department of Surgery (J.D.), University of California San Diego Health, San Diego, California; Department of Surgery (P.J.), Indiana University School of Medicine, Indianapolis, Indiana; Department of Pediatrics (N.C.M.), University of Utah School of Medicine, Salt Lake City, Utah; Department of Surgery (K.S.), Stanford University, Palo Alto, California; Department of Surgery (D.P.B.), Inova Medical Group/Inova Fairfax Medical Campus, Falls Church, Virginia; and Department of Surgery (E.B.), Harborview Medical Center University of Washington, Seattle, Washington.

Submitted: August 18, 2021, Revised: September 30, 2021, Accepted: October 4, 2021, Published online: November 15, 2021.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text, and links to the digital files are provided in the HTML text of this article on the journal’s Web site (www.jtrauma.com).

Address for reprints: Craig D. Newgard, MD, MPH, Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Mail Code CR-114, Portland, OR 97239-3098; email: [email protected].

Journal of Trauma and Acute Care Surgery 92(2):p 398-406, February 2022. | DOI: 10.1097/TA.0000000000003469
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BACKGROUND 

The National Academies of Sciences, Engineering, and Medicine 2016 trauma system report recommended a National Trauma Research Action Plan to strengthen and guide future trauma research. To address this recommendation, 11 expert panels completed a Delphi survey process to create a comprehensive research agenda, spanning the continuum of trauma care. We describe the gap analysis and high-priority research questions generated from the National Trauma Research Action Plan panel on prehospital and mass casualty trauma care.

METHODS 

We recruited interdisciplinary national experts to identify gaps in the prehospital and mass casualty trauma evidence base and generate prioritized research questions using a consensus-driven Delphi survey approach. We included military and civilian representatives. Panelists were encouraged to use the Patient/Population, Intervention, Compare/Control, and Outcome format to generate research questions. We conducted four Delphi rounds in which participants generated key research questions and then prioritized the questions on a 9-point Likert scale to low-, medium-, and high-priority items. We defined consensus as ≥60% agreement on the priority category and coded research questions using a taxonomy of 118 research concepts in 9 categories.

RESULTS 

Thirty-one interdisciplinary subject matter experts generated 490 research questions, of which 433 (88%) reached consensus on priority. The rankings of the 433 questions were as follows: 81 (19%) high priority, 339 (78%) medium priority, and 13 (3%) low priority. Among the 81 high-priority questions, there were 46 taxonomy concepts, including health systems of care (36 questions), interventional clinical trials and comparative effectiveness (32 questions), mortality as an outcome (30 questions), prehospital time/transport mode/level of responder (24 questions), system benchmarks (17 questions), and fluid/blood product resuscitation (17 questions).

CONCLUSION 

This Delphi gap analysis of prehospital and mass casualty care identified 81 high-priority research questions to guide investigators and funding agencies for future trauma research.

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