Developing a National Trauma Research Action Plan: Results from the prehospital and mass casualty research Delphi survey

BACKGROUND: The National Academies of Sciences, Engineering, and Medicine 2016 trauma system report recommended a National Trauma Research Action Plan to strengthen and guide future trauma research. To address this recommendation. 11 expert panels completed a Delphi survey process to create a comprehensive research agenda, spanning the continuum of trauma care. We describe the gap analysis and high-priority research questions generated frorn the National Trauma Research Action Plan panel on prehospital and mass casualty trauma care. METHODS: We recruited interdisciplinary national experts to identify gaps in the prehospital and mass casualty trauma evidence base and generate prioritized research questions using a consensus-driven Delphi survey approach. We included military and civilian representatives. Panelists were encouraged to use the Patient/Population, Intervention, Compare/Control, and Outcome format to generate research questions. We conducted four Delphi rounds in which participants generated key research questions and then prioritized the questions on a 9-point Liken scale to low-, medium-, and high-priority items. We defined consensus as >= 60% agreement on the priority category and coded research questions using a taxonomy of 118 research concepts in 9 categories. RESULTS: Thirty-one interdisciplinary subject matter experts generated 490 research questions, of which 433 (88%) reached consensus on priority. The rankings of the 433 questions were as follows: 81 (19%) high priority, 339 (78%) medium priority, and 13 (3%) low priority. Among the 81 high-priority questions, there were 46 taxonomy concepts, including health systems of care (36 questions), interventional clinical trials and comparative effectiveness (32 questions), mortality as an outcome (30 questions), prehospital time/transport mode/level of responder (24 questions), system benchmarks (17 questions), and fluithblood product resuscitation (17 questions). CONCLUSION: This Delphi gap analysis of prehospital and mass casualty care identified 81 high-priority research questions to guide investigators and funding agen- cies for future trauma research. Copyright (C) 2021 Wolters Kluwer Health, Inc. All rights reserved.

Automated summary

An analysis using the Delphi method identified 81 high-priority research questions for prehospital and mass casualty care. These questions cover areas such as health systems of care, clinical trials, comparative effectiveness, mortality outcomes, and prehospital time.