From the Department of Surgery (K.J.B.), Oregon Health Sciences University, Portland, Oregon; Coalition for National Trauma Research (M.A.B., M.A.P.), San Antonio, Texas; Perelman School of Medicine (L.J.K.), University of Pennsylvania, Philadelphia, Pennsylvania; University of Maryland School of Medicine (R.K.), Baltimore, Maryland; Inova Fairfax Hospital (C.P.M.), Falls Church, Virginia; University of California Davis (R.C.), Davis, California; Department of Surgery (E.M.B.), Harborview Medical Center, University of Washington, Seattle, Washington; and Department of Biomedical Informatics and Medical Education (J.P.), University of Washington, Seattle, Washington.
J Trauma Acute Care Surg. 2022 Dec 1;93(6):846-853. doi: 10.1097/TA.0000000000003754. Epub 2022 Aug 2.
The 2016 National Academies of Science, Engineering and Medicine report included a proposal to establish a National Trauma Research Action Plan. In response, 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 from prehospital care to rehabilitation as part of an overall strategy to achieve zero preventable deaths and disability after injury. The Postadmission Critical Care Research panel was 1 of 11 panels constituted to develop this research agenda.
We recruited interdisciplinary experts in surgical critical care and recruited them to identify current gaps in clinical critical care research, generate research questions, and establish the priority of these questions using a consensus-driven Delphi survey approach. The first of four survey rounds asked participants to generate key research questions. On subsequent rounds, we asked survey participants to rank the priority of each research question on a 9-point Likert scale, categorized to represent low-, medium-, and high-priority items. Consensus was defined as ≥60% of panelists agreeing on the priority category.
Twenty-five subject matter experts generated 595 questions. By Round 3, 249 questions reached ≥60% consensus. Of these, 22 questions were high, 185 were medium, and 42 were low priority. The clinical states of hypovolemic shock and delirium were most represented in the high-priority questions. Traumatic brain injury was the only specific injury pattern with a high-priority question.
The National Trauma Research Action Plan critical care research panel identified 22 high-priority research questions, which, if answered, would reduce preventable death and disability after injury.
Diagnostic Tests or Criteria; Level IV.
2016 年，美国国家科学院、工程院和医学院的报告提出了制定国家创伤研究行动计划的建议。作为回应，美国国防部资助了“国家创伤研究联盟”，以制定一项涵盖从创伤前医疗到康复的创伤和烧伤护理全过程的综合研究议程，作为实现受伤后零可预防死亡和残疾的整体战略的一部分。住院后重症监护研究小组是 11 个小组之一，负责制定这一研究议程。
我们招募了外科重症监护领域的跨学科专家，并招募他们来确定临床重症监护研究中的当前差距，生成研究问题，并使用共识驱动的 Delphi 调查方法确定这些问题的优先级。四轮调查中的第一轮要求参与者提出关键研究问题。在随后的几轮调查中，我们要求调查参与者根据 9 分李克特量表对每个研究问题的优先级进行排名，分类表示低、中、高优先级项目。共识定义为≥60%的小组成员同意优先级类别。
25 名主题专家提出了 595 个问题。到第 3 轮，有 249 个问题达到了≥60%的共识。其中，22 个问题是高优先级，185 个是中优先级，42 个是低优先级。低血容量性休克和谵妄的临床状态在高优先级问题中最为突出。创伤性脑损伤是唯一具有高优先级问题的特定损伤模式。
国家创伤研究行动计划重症监护研究小组确定了 22 个高优先级研究问题，如果这些问题得到回答，将减少受伤后的可预防死亡和残疾。
诊断测试或标准；四级。
