Trauma is a major cause of death and disability in all ages. Previous reviews have suggested that NIH funding for trauma is not commensurate with its burden of disease, but a detailed analysis has been lacking. We postulated that NIH spending on trauma research was lower than previously thought and was distributed widely, preventing a comprehensive research strategy that could decrease trauma morbidity and mortality.
The NIH Research Portfolio Online Reporting Tool was initially screened using a search of over 20 terms including ‘trauma’, ‘injury’, ‘shock’, ‘MVC’ and excluding clearly unrelated conditions e.g. ‘cancer.’ The details of all grants that screened positive underwent manual review to identify true trauma-related grants. An expert panel was used to adjudicate any ambiguity.
In FY2016, NIH awarded 50,137 grants of which 6,401 (13%) were captured by our initial screen. Following review, 1,888 (28%) were identified as trauma related; 3.7% of all NIH grants. These grants ($720million) represent only 2.9% of the NIH extramural budget. In addition, the grants were funded and administered by 24 of the institutes and centers across the NIH ranging from 0.01% (NCI) to 11% (NINDS and NIAMS) of their extramural portfolios.
Given the extreme burden of trauma related disability and years of life lost, this review of extramural NIH funding definitively demonstrates that trauma is severely underfunded. The lack of a dedicated home for trauma research at NIH leads to a diffusion of grants across many institutes and makes it impossible to direct a focused and effective national research endeavor to improve outcomes. These data demonstrate the need for a National Institute of Trauma at the NIH to help set an agenda to reach the national goal of Zero Preventable Deaths.
Epidemiological Level III
Department of Surgery, Division of Trauma and Surgical Critical Care, Rutgers-New Jersey Medical School, Newark, New Jersey
Corresponding Author: Nina E. Glass, MD, FACS, University Hospital M237A, 150 Bergen Street, Newark, New Jersey 07103. E-mail: email@example.com
No conflicts of interest to disclose
This study will be presented at the 78th Annual Meeting of the American Association for the Surgery of Trauma and Clinical Congress of Acute Care Surgery, September 18-21, 2019, in Dallas, Texas.