Title

Developing a National Trauma Research Action Plan (NTRAP): Results from the Neurotrauma Research Panel Delphi Survey

Authors

Deborah M. Stein, Program in Trauma, University of Maryland School of Medicine, Baltimore, Maryland Coalition for National Trauma Research, San Antonio, Texas Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, Washington Department of Neurosurgery, Mayo Clinic, Barrow Neurological Institute at Phoenix Children's Hospital, Division of Neurosurgery, Department of Child Health, University of Arizona, Phoenix, Arizona Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, Indiana Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia Augusta University Health, Augusta, Georgia Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, Maryland Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland Department of Neurosurgery, Stanford University, Palo Alto, California Department of Emergency Medicine, Madigan Army Medicine Center, Tacoma, WA Department of Neurosurgery, McGovern Medical School, Houston, Texas R Adams Cowley Shock Trauma Center, University of Maryland Medical Center, Baltimore, Maryland Department of Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee Department of Neurosurgery, Baylor College of Medicine, Houston, Texas Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts Departments of Critical Care Medicine, Neurology & Neurosurgery, University of Pittsburg, Pittsburgh, Pennsylvania Department of Neurosurgery, Virginia Commonwealth University School of Medicine, Richmond, Virginia Department of Surgery, Harborview Medical Center, University of Washington, Seattle, Washington Department of Neurosurgery, Harborview Medical Center, University of Washington, Seattle, Washington Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts Department of Neurosurgery, University of Manitoba, Winnipeg, Manitoba Department of Neurosurgery, University of California, San Francisco School of Medicine, San Francisco, California Department of Emergency Medicine, UF College of Medicine, Gainesville, Florida Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania Joint Trauma System, Combat Support Agency, Defense Health Agency Departments of Neurology and Neurosurgery, Yale School of Medicine, New Haven, Connecticut Department of Surgery, McGovern Medical School, Houston, Texas Moss Rehabilitation Research Institute, Elkins Park, Pennsylvania.
Maxwell A. Braverman
Jimmy Phuong
Edward Shipper
Michelle A. Price
Pamela J. Bixby
P David Adelson
Beth M. Ansel
David X. Cifu
John G. DeVine
Samuel M. Galvagno
Daniel E. Gelb
Odette Harris
Christopher S. Kang
Ryan S. Kitagawa
Karen A. McQuillan
Mayur B. Patel
Claudia S. Robertson
Ali Salim
Lori Shutter
Alex B. Valadka
Eileen M. Bulger
P David Adelson
Beth M. Ansel
Randall M. Chesnut
David X. Cifu
John G. DeVine
Samuel M. Galvagno
Daniel E. Gelb
Joseph T. Giacino
Odette Harris
Gregory Hawryluk
Christopher S. Kang

Document Type

Article

Publication Title

The journal of trauma and acute care surgery

Abstract

BACKGROUND: In 2016, the National Academies of Science, Engineering and Medicine (NASEM) called for the development of a National Trauma Research Action Plan (NTRAP). The Department of Defense funded the Coalition for National Trauma Research (CNTR) to generate a comprehensive research agenda spanning the continuum of trauma and burn care. Given the public health burden of injuries to the central nervous system, Neurotrauma was one of 11 panels formed to address this recommendation with a gap analysis and generation of high-priority research questions. METHODS: We recruited interdisciplinary experts to identify gaps in the neurotrauma literature, generate research questions, and prioritize those questions using a consensus-driven Delphi survey approach. We conducted four Delphi rounds in which participants generated key research questions and then prioritized the importance of the questions on a 9-point Likert scale. Consensus was defined as ≥60% of panelists agreeing on the priority category. We then coded research questions using an NTRAP taxonomy of 118 research concepts, which were consistent across all 11 panels. RESULTS: Twenty-eight neurotrauma experts generated 675 research questions. Of these, 364 (53.9%) reached consensus, and 56 were determined to be high priority (15.4%), 303 were deemed to be medium priority (83.2%), and 5 were low priority (1.4%). The research topics were stratified into three groups - severe traumatic brain injury (TBI), mild TBI (mTBI), and spinal cord injury (SCI). The number of high-priority questions for each subtopic was 46 for severe TBI (19.7%), 3 for mTBI (4.3%) and 7 for SCI (11.7%). CONCLUSIONS: This Delphi gap analysis of neurotrauma research identified 56 high-priority research questions. There are clear areas of focus for severe TBI, mild TBI and SCI that will help guide investigators in future neurotrauma research. Funding agencies should consider these gaps when they prioritize future research. LEVEL OF EVIDENCE: IV. TYPE OF STUDY: Delphi panel gap analyses.

DOI

10.1097/TA.0000000000003527

Publication Date

1-6-2022

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