From the Center for Surgery and Public Health (J.P.H.-E., E.R., A.H.H.), Brigham and Women's Hospital, Harvard Medical School, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Biomedical Informatics and Medical Education (J.P.), University of Washington, Seattle, Washington; Division of Trauma, Critical Care and Acute Care Surgery (K.J.B.), Oregon Health and Science University, Portland, Oregon; Department of Surgery (J.C.), University of San Francisco California, San Francisco, California; Department of Surgery (M.F.), University of Louisville, Louisville, Kentucky; Walter Reed Department of Surgery (B.K.P.), Uniformed Services University, Bethesda, Maryland; Coalition for National Trauma Research (M.A.P.), San Antonio, Texas; Department of Surgery (E.M.B.), University of Washington, Seattle, Washington; Office of the Dean, Aga Khan University Medical College (A.H.H.), Karachi, Pakistan.
J Trauma Acute Care Surg. 2022 Dec 1;93(6):854-862. doi: 10.1097/TA.0000000000003747. Epub 2022 Aug 16.
In the National Academies of Sciences, Engineering, and Medicine 2016 report on trauma care, the establishment of a National Trauma Research Action Plan to strengthen and guide future trauma research was recommended. To address this recommendation, 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. We describe the gap analysis and high-priority research questions generated from the National Trauma Research Action Plan panel on long-term outcomes.
Experts in long-term outcomes were recruited to identify current gaps in long-term trauma outcomes research, generate research questions, and establish the priority for these questions using a consensus-driven, Delphi survey approach from February 2021 to August 2021. Panelists were identified using established Delphi recruitment guidelines to ensure heterogeneity and generalizability including both military and civilian representation. Panelists were encouraged to use a PICO format to generate research questions: Patient/Population, Intervention, Compare/Control, and Outcome model. On subsequent surveys, panelists were asked to prioritize 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.
Thirty-two subject matter experts generated 482 questions in 17 long-term outcome topic areas. By Round 3 of the Delphi, 359 questions (75%) reached consensus, of which 107 (30%) were determined to be high priority, 252 (70%) medium priority, and 0 (0%) low priority. Substance abuse and pain was the topic area with the highest number of questions. Health services (not including mental health or rehabilitation) (64%), mental health (46%), and geriatric population (43%) were the topic areas with the highest proportion of high-priority questions.
This Delphi gap analysis of long-term trauma outcomes research identified 107 high-priority research questions that will help guide investigators in future long-term outcomes research.
Diagnostic Tests or Criteria; Level IV.
在 2016 年美国国家科学院、工程院和医学院关于创伤护理的报告中，建议建立国家创伤研究行动计划，以加强和指导未来的创伤研究。为了落实这一建议，美国国防部资助了“国家创伤研究联盟”，以制定涵盖创伤和烧伤护理各个方面的综合研究议程。我们描述了根据国家创伤研究行动计划小组提出的长期结果的差距分析和高优先级研究问题。
招募长期结果方面的专家，以确定长期创伤结果研究中的当前差距，生成研究问题，并使用共识驱动的 Delphi 调查方法（从 2021 年 2 月至 2021 年 8 月）确定这些问题的优先级。使用既定的 Delphi 招聘准则确定小组委员会成员，以确保异质性和普遍性，包括军事和民用代表。鼓励小组成员使用 PICO 格式生成研究问题：患者/人群、干预、比较/对照和结果模型。在随后的调查中，小组成员被要求根据 9 分李克特量表对每个研究问题进行优先级排序，分为低、中、高三级。共识定义为≥60%的小组成员对优先级类别达成一致。
32 名主题专家在 17 个长期结果主题领域生成了 482 个问题。在 Delphi 的第 3 轮中，有 359 个问题（75%）达成共识，其中 107 个（30%）被确定为高优先级，252 个（70%）为中优先级，0 个（0%）为低优先级。物质滥用和疼痛是问题最多的主题领域。卫生服务（不包括心理健康或康复）（64%）、心理健康（46%）和老年人口（43%）是高优先级问题比例最高的主题领域。
这项针对长期创伤结果研究的 Delphi 差距分析确定了 107 个高优先级研究问题，这将有助于指导未来长期结果研究的研究人员。
诊断测试或标准；四级。
