制定国家创伤研究行动计划：神经创伤研究小组德尔菲调查结果
Developing a National Trauma Research Action Plan: Results from the Neurotrauma Research Panel Delphi Survey.
作者信息
Stein Deborah M, Braverman Maxwell A, Phuong Jimmy, Shipper Edward, Price Michelle A, Bixby Pamela J, Adelson P David, Ansel Beth M, Cifu David X, DeVine John G, Galvagno Samuel M, Gelb Daniel E, Harris Odette, Kang Christopher S, Kitagawa Ryan S, McQuillan Karen A, Patel Mayur B, Robertson Claudia S, Salim Ali, Shutter Lori, Valadka Alex B, Bulger Eileen M
机构信息
From the Program in Trauma, University of Maryland School of Medicine (D.M.S.), Baltimore, Maryland; Department of Biomedical Informatics and Medical Education (J.P.), University of Washington, Seattle, Washington; Coalition for National Trauma Research (M.A.B., E.S., M.A.P., P.J.B.), San Antonio, Texas; Department of Neurosurgery, Mayo Clinic (P.D.A.), Barrow Neurological Institute at Phoenix Children's Hospital; Division of Neurosurgery, Department of Child Health (P.D.A.), University of Arizona, Phoenix, Arizona; Department of Neurological Surgery (B.M.A.), Indiana University School of Medicine, Indianapolis, Indiana; Department of Physical Medicine and Rehabilitation (D.X.C.), Virginia Commonwealth University School of Medicine, Richmond, Virginia; Department of Orthopaedics, Augusta University Health (J.G.D.), Augusta, Georgia; Department of Anesthesiology (S.M.G.), Department of Orthopaedics (D.E.G.), University of Maryland School of Medicine, Baltimore, Maryland; Department of Neurosurgery (O.H.), Stanford University, Palo Alto, California; Department of Emergency Medicine (C.S.K.), Madigan Army Medicine Center, Tacoma, Washington; Department of Neurosurgery (R.S.K.), McGovern Medical School, Houston, Texas; R Adams Cowley Shock Trauma Center (K.A.M.), University of Maryland Medical Center, Baltimore, Maryland; Department of Surgery (M.B.P.), Vanderbilt University School of Medicine, Nashville, Tennessee; Department of Neurosurgery (C.S.R.), Baylor College of Medicine, Houston, Texas; Department of Surgery (A.S.), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Department of Critical Care Medicine (L.S.), Neurology & Neurosurgery, University of Pittsburg, Pittsburgh, Pennsylvania; Department of Neurosurgery (A.B.V.), Virginia Commonwealth University School of Medicine, Richmond, Virginia; Department of Surgery (E.M.B.), Harborview Medical Center, University of Washington, Seattle, Washington.
出版信息
J Trauma Acute Care Surg. 2022 May 1;92(5):906-915. doi: 10.1097/TA.0000000000003527. Epub 2022 Jan 6.
BACKGROUND
In 2016, the National Academies of Science, Engineering and Medicine called for the development of a National Trauma Research Action Plan. The Department of Defense funded the Coalition for National Trauma Research 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% or greater of panelists agreeing on the priority category. We then coded research questions using an National Trauma Research Action Plan 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. 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%).
CONCLUSION
This Delphi gap analysis of neurotrauma research identified 56 high-priority research questions. There are clear areas of focus for severe TBI, mTBI, and spinal cord injury that will help guide investigators in future neurotrauma research. Funding agencies should consider these gaps when they prioritize future research.
LEVEL OF EVIDENCE
Diagnostic Test or Criteria, Level IV.
背景
2016年，美国国家科学院、工程院和医学院呼吁制定一项国家创伤研究行动计划。美国国防部资助了国家创伤研究联盟，以制定一项涵盖创伤和烧伤护理全过程的综合研究议程。鉴于中枢神经系统损伤对公众健康造成的负担，神经创伤是为落实这一建议而成立的11个小组之一，负责进行差距分析并提出高度优先的研究问题。
方法
我们招募了跨学科专家，以识别神经创伤文献中的差距，提出研究问题，并使用基于共识的德尔菲调查方法对这些问题进行优先排序。我们进行了四轮德尔菲调查，参与者提出关键研究问题，然后在9点李克特量表上对问题的重要性进行优先排序。共识的定义是60%或更多的小组成员在优先类别上达成一致。然后，我们使用国家创伤研究行动计划的118个研究概念分类法对研究问题进行编码，该分类法在所有11个小组中都是一致的。
结果
28名神经创伤专家提出了675个研究问题。其中，364个（53.9%）达成了共识，56个被确定为高度优先（15.4%），303个被认为是中度优先（83.2%），5个是低度优先（1.4%）。研究主题分为三组——重度创伤性脑损伤（TBI）、轻度TBI（mTBI）和脊髓损伤。每个子主题的高度优先问题数量分别为重度TBI 46个（19.7%）、mTBI 3个（4.
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