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

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Developing a National Trauma Research Action Plan (NTRAP): Results from the Neurotrauma Research Panel Delphi Survey. The journal of trauma and acute care surgery Stein, D. M., Braverman, M. A., Phuong, J., Shipper, E., Price, M. A., Bixby, P. J., Adelson, P. D., Ansel, B. M., Cifu, D. X., DeVine, J. G., Galvagno, S. M., Gelb, D. E., Harris, O., Kang, C. S., Kitagawa, R. S., McQuillan, K. A., Patel, M. B., Robertson, C. S., Salim, A., Shutter, L., Valadka, A. B., Bulger, E. M., Adelson, P. D., Ansel, B. M., Chesnut, R. M., Cifu, D. X., DeVine, J. G., Galvagno, S. M., Gelb, D. E., Giacino, J. T., Harris, O., Hawryluk, G., Kang, C. S., Kitagawa, R. S., Manley, G. T., McQuillan, K. A., Merck, L. H., Okonkwo, D. O., Patel, M. B., Robertson, C. S., Salim, A., Shackelford, C. S., Sheth, K. N., Shutter, L., Stein, D. M., Valadka, A. B., Wade, C. E., Whyte, J., And the NTRAP Neurotrauma Panel Group 1800

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 À¶Ý®ÊÓƵ 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 À¶Ý®ÊÓƵ questions.METHODS: We recruited interdisciplinary experts to identify gaps in the neurotrauma literature, generate À¶Ý®ÊÓƵ questions, and prioritize those questions using a consensus-driven Delphi survey approach. We conducted four Delphi rounds in which participants generated key À¶Ý®ÊÓƵ 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 À¶Ý®ÊÓƵ questions using an NTRAP taxonomy of 118 À¶Ý®ÊÓƵ concepts, which were consistent across all 11 panels.RESULTS: Twenty-eight neurotrauma experts generated 675 À¶Ý®ÊÓƵ 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 À¶Ý®ÊÓƵ 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 À¶Ý®ÊÓƵ identified 56 high-priority À¶Ý®ÊÓƵ questions. There are clear areas of focus for severe TBI, mild TBI and SCI that will help guide investigators in future neurotrauma À¶Ý®ÊÓƵ. Funding agencies should consider these gaps when they prioritize future À¶Ý®ÊÓƵ.LEVEL OF EVIDENCE: IV.TYPE OF STUDY: Delphi panel gap analyses.

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