This month, a Research Methodology conference hosted by the American College of Surgeons Committee on Trauma (ACS COT) and the Coalition for National Trauma Research (CNTR) took a step closer toward matching research efforts with the societal burden of traumatic injury. Long the #1 cause of death from age 1-46 and the #3 cause of death overall in the United States, traumatic injury ranks last in NIH funding relative to the public health burden of disease.
Despite the significant need for new treatments and devices to save lives and minimize disability following traumatic injury, it remains tremendously difficult to conduct trauma-related research that adds to knowledge in the field. The emergency context, complications due to multiple and complex injuries, lack of funding, and inability to obtain informed consent are just some of the reasons that make such research particularly troublesome.
Speakers at the conference addressed novel approaches to study design—including pragmatic alternatives to randomized clinical trials–that could overcome traditional barriers to trauma research. The conference also aimed to generate research frameworks that will eventually mesh with the National Trauma Research Action Plan (NTRAP) that CNTR is currently developing with the support of a Department of Defense grant.
“Proving that there is always more to learn, a group of prolific and experienced researchers got the privilege of hearing about a variety of ‘non-traditional’ research methodologies,” said Dr. Deborah Stein, an NTRAP Panel Leader. “How these methodologies can be applied to injury research is the question going forward.”Members of the CNTR Scientific Advisory Council attended the meeting and the next day met to brainstorm novel strategies to answer important questions.
Among the presenters, Dr. Avery Nathens, Medical Director for Trauma Quality Programs at the ACS, discussed the potential for better utilizing the ACS Trauma Quality Improvement Program (TQIP) as infrastructure to conduct clinical trials; Dr. Carly Parry, a senior advisor on Healthcare Delivery and Disparities Research for the Patient-Centered Outcomes Research Institute (PCORI) offered strategies for obtaining research funding through PCORI, particularly for comparative effectiveness research; and Dr. David Chambers, a Deputy Director for Implementation Science at the National Cancer Institute shared the NIH perspective on methods of implementation science. Additional speakers included experts on adaptive trial design, platform trials, pragmatic clinical trials, and de-implementation studies.
Those in attendance included both experienced and emerging surgical researchers, all nominated by the CNTR organization member groups: the American Association for the Surgery of Trauma (AAST), National Trauma Institute (NTI), Eastern Association for the Surgery of Trauma (EAST), American College of Surgeons Committee on Trauma (ACS COT) and the Western Trauma Association (WTA). Members of the American College of Emergency Physicians and the Pediatric Trauma Society also participated.
Dr. Eileen Bulger, Chair of the ACS COT, noted, “This was an exciting opportunity to bring the trauma community together to explore innovative approaches to trauma research. While we continue to advocate for research funding commensurate with the burden of disease, we must think outside the box and develop novel approaches to answer the fundamental questions that impact the outcome of our patients.”
The American College of Surgeons (ACS) is a scientific and educational association of surgeons that aims to improve the quality of care for the surgical patient, and its Committee on Trauma (COT) works to develop and implement meaningful programs for trauma care in local, regional, national, and international arenas. The Coalition for National Trauma Research (CNTR) combines the strengths and resources of AAST, EAST, NTI, ACS COT and WTA to advocate for federal funding for trauma research, coordinate research efforts across professional organizations spanning the continuum of care and enhance the infrastructure for multicenter investigation. Under the leadership of Dr. Rosemary Kozar, the CNTR Scientific Advisory Council is committed to working together to design and implement these novel approaches to advance the field. Learn more at CoalitionNTR.org.