The "Top 10" research and development priorities for battlefield surgical care

Results from the Committee on Surgical Combat Casualty Care research gap analysis

Matthew J. Martin, John B. Holcomb, Travis Polk, Matthew Hannon, Brian Eastridge, Saafan Z. Malik, Virginia S. Blackman, Joseph M. Galante, Daniel Grabo, Martin Schreiber, Jennifer Gurney, Frank K. Butler, Stacy Shackelford

    Research output: Contribution to journalArticle

    1 Citation (Scopus)

    Abstract

    BACKGROUND: The US Military has achieved the highest casualty survival rates in its history. However, there remain multiple areas in combat trauma that present challenges to the delivery of high-quality and effective trauma care. Previous work has identified research priorities for pre-hospital care, but there has been no similar analysis for forward surgical care. METHODS: A list of critical "focus areas" was developed by the Committee on Surgical Combat Casualty Care (CoSCCC). Individual topics were solicited and mapped to appropriate focus areas by group consensus and review of Eastern Association for the Surgery of Trauma (EAST) and Joint Trauma System guidelines. A web-based survey was distributed to the CoSCCC and the military committees of EAST and the American Association for the Surgery of Trauma. Topics were rated on a Likert scale from 1 (low) to 10 (high priority). Descriptives, univariate statistics, and inter-rater correlation analysis was performed. RESULTS: 13 research focus areas were identified (eight clinical and five adjunctive categories). Ninety individual topics were solicited. The survey received 64 responses. The majority of respondents were military (90%) versus civilians (10%). There was moderate to high agreement (inter-rater correlation coefficient = 0.93, p < 0.01) for 10 focus areas. The top five focus areas were Personnel/Staffing (mean, 8.03), Resuscitation and Hemorrhage Management (7.49), Pain/Sedation/Anxiety Management (6.96), Operative Interventions (6.9), and Initial Evaluation (6.9). The "Top 10" research priorities included four in Personnel/Staffing, four in Resuscitation/Hemorrhage Management, and three in Operative Interventions. A complete list of the topics/scores will be presented. CONCLUSIONS: This is the first objective ranking of research priorities for combat trauma care. The "Top 10" priorities were all from three focus areas, supporting prioritization of personnel/staffing of austere teams, resuscitation/hemorrhage control, and damage-control interventions. This data will help guide Department of Defense research programs and new areas for prioritized funding of both military and civilian researchers. LEVEL OF EVIDENCE: Study design, level IV.

    Original languageEnglish (US)
    Pages (from-to)S14-S21
    JournalThe journal of trauma and acute care surgery
    Volume87
    Issue number1S Suppl 1
    DOIs
    StatePublished - Jul 1 2019

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    Personnel Staffing and Scheduling
    Wounds and Injuries
    Research
    Resuscitation
    Hemorrhage
    Pain Management
    Focus Groups
    Consensus
    Anxiety
    Joints
    History
    Research Personnel
    Guidelines
    Surveys and Questionnaires

    ASJC Scopus subject areas

    • Surgery
    • Critical Care and Intensive Care Medicine

    Cite this

    The "Top 10" research and development priorities for battlefield surgical care : Results from the Committee on Surgical Combat Casualty Care research gap analysis. / Martin, Matthew J.; Holcomb, John B.; Polk, Travis; Hannon, Matthew; Eastridge, Brian; Malik, Saafan Z.; Blackman, Virginia S.; Galante, Joseph M.; Grabo, Daniel; Schreiber, Martin; Gurney, Jennifer; Butler, Frank K.; Shackelford, Stacy.

    In: The journal of trauma and acute care surgery, Vol. 87, No. 1S Suppl 1, 01.07.2019, p. S14-S21.

    Research output: Contribution to journalArticle

    Martin, MJ, Holcomb, JB, Polk, T, Hannon, M, Eastridge, B, Malik, SZ, Blackman, VS, Galante, JM, Grabo, D, Schreiber, M, Gurney, J, Butler, FK & Shackelford, S 2019, 'The "Top 10" research and development priorities for battlefield surgical care: Results from the Committee on Surgical Combat Casualty Care research gap analysis', The journal of trauma and acute care surgery, vol. 87, no. 1S Suppl 1, pp. S14-S21. https://doi.org/10.1097/TA.0000000000002200
    Martin, Matthew J. ; Holcomb, John B. ; Polk, Travis ; Hannon, Matthew ; Eastridge, Brian ; Malik, Saafan Z. ; Blackman, Virginia S. ; Galante, Joseph M. ; Grabo, Daniel ; Schreiber, Martin ; Gurney, Jennifer ; Butler, Frank K. ; Shackelford, Stacy. / The "Top 10" research and development priorities for battlefield surgical care : Results from the Committee on Surgical Combat Casualty Care research gap analysis. In: The journal of trauma and acute care surgery. 2019 ; Vol. 87, No. 1S Suppl 1. pp. S14-S21.
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    abstract = "BACKGROUND: The US Military has achieved the highest casualty survival rates in its history. However, there remain multiple areas in combat trauma that present challenges to the delivery of high-quality and effective trauma care. Previous work has identified research priorities for pre-hospital care, but there has been no similar analysis for forward surgical care. METHODS: A list of critical {"}focus areas{"} was developed by the Committee on Surgical Combat Casualty Care (CoSCCC). Individual topics were solicited and mapped to appropriate focus areas by group consensus and review of Eastern Association for the Surgery of Trauma (EAST) and Joint Trauma System guidelines. A web-based survey was distributed to the CoSCCC and the military committees of EAST and the American Association for the Surgery of Trauma. Topics were rated on a Likert scale from 1 (low) to 10 (high priority). Descriptives, univariate statistics, and inter-rater correlation analysis was performed. RESULTS: 13 research focus areas were identified (eight clinical and five adjunctive categories). Ninety individual topics were solicited. The survey received 64 responses. The majority of respondents were military (90{\%}) versus civilians (10{\%}). There was moderate to high agreement (inter-rater correlation coefficient = 0.93, p < 0.01) for 10 focus areas. The top five focus areas were Personnel/Staffing (mean, 8.03), Resuscitation and Hemorrhage Management (7.49), Pain/Sedation/Anxiety Management (6.96), Operative Interventions (6.9), and Initial Evaluation (6.9). The {"}Top 10{"} research priorities included four in Personnel/Staffing, four in Resuscitation/Hemorrhage Management, and three in Operative Interventions. A complete list of the topics/scores will be presented. CONCLUSIONS: This is the first objective ranking of research priorities for combat trauma care. The {"}Top 10{"} priorities were all from three focus areas, supporting prioritization of personnel/staffing of austere teams, resuscitation/hemorrhage control, and damage-control interventions. This data will help guide Department of Defense research programs and new areas for prioritized funding of both military and civilian researchers. LEVEL OF EVIDENCE: Study design, level IV.",
    author = "Martin, {Matthew J.} and Holcomb, {John B.} and Travis Polk and Matthew Hannon and Brian Eastridge and Malik, {Saafan Z.} and Blackman, {Virginia S.} and Galante, {Joseph M.} and Daniel Grabo and Martin Schreiber and Jennifer Gurney and Butler, {Frank K.} and Stacy Shackelford",
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    T2 - Results from the Committee on Surgical Combat Casualty Care research gap analysis

    AU - Martin, Matthew J.

    AU - Holcomb, John B.

    AU - Polk, Travis

    AU - Hannon, Matthew

    AU - Eastridge, Brian

    AU - Malik, Saafan Z.

    AU - Blackman, Virginia S.

    AU - Galante, Joseph M.

    AU - Grabo, Daniel

    AU - Schreiber, Martin

    AU - Gurney, Jennifer

    AU - Butler, Frank K.

    AU - Shackelford, Stacy

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    N2 - BACKGROUND: The US Military has achieved the highest casualty survival rates in its history. However, there remain multiple areas in combat trauma that present challenges to the delivery of high-quality and effective trauma care. Previous work has identified research priorities for pre-hospital care, but there has been no similar analysis for forward surgical care. METHODS: A list of critical "focus areas" was developed by the Committee on Surgical Combat Casualty Care (CoSCCC). Individual topics were solicited and mapped to appropriate focus areas by group consensus and review of Eastern Association for the Surgery of Trauma (EAST) and Joint Trauma System guidelines. A web-based survey was distributed to the CoSCCC and the military committees of EAST and the American Association for the Surgery of Trauma. Topics were rated on a Likert scale from 1 (low) to 10 (high priority). Descriptives, univariate statistics, and inter-rater correlation analysis was performed. RESULTS: 13 research focus areas were identified (eight clinical and five adjunctive categories). Ninety individual topics were solicited. The survey received 64 responses. The majority of respondents were military (90%) versus civilians (10%). There was moderate to high agreement (inter-rater correlation coefficient = 0.93, p < 0.01) for 10 focus areas. The top five focus areas were Personnel/Staffing (mean, 8.03), Resuscitation and Hemorrhage Management (7.49), Pain/Sedation/Anxiety Management (6.96), Operative Interventions (6.9), and Initial Evaluation (6.9). The "Top 10" research priorities included four in Personnel/Staffing, four in Resuscitation/Hemorrhage Management, and three in Operative Interventions. A complete list of the topics/scores will be presented. CONCLUSIONS: This is the first objective ranking of research priorities for combat trauma care. The "Top 10" priorities were all from three focus areas, supporting prioritization of personnel/staffing of austere teams, resuscitation/hemorrhage control, and damage-control interventions. This data will help guide Department of Defense research programs and new areas for prioritized funding of both military and civilian researchers. LEVEL OF EVIDENCE: Study design, level IV.

    AB - BACKGROUND: The US Military has achieved the highest casualty survival rates in its history. However, there remain multiple areas in combat trauma that present challenges to the delivery of high-quality and effective trauma care. Previous work has identified research priorities for pre-hospital care, but there has been no similar analysis for forward surgical care. METHODS: A list of critical "focus areas" was developed by the Committee on Surgical Combat Casualty Care (CoSCCC). Individual topics were solicited and mapped to appropriate focus areas by group consensus and review of Eastern Association for the Surgery of Trauma (EAST) and Joint Trauma System guidelines. A web-based survey was distributed to the CoSCCC and the military committees of EAST and the American Association for the Surgery of Trauma. Topics were rated on a Likert scale from 1 (low) to 10 (high priority). Descriptives, univariate statistics, and inter-rater correlation analysis was performed. RESULTS: 13 research focus areas were identified (eight clinical and five adjunctive categories). Ninety individual topics were solicited. The survey received 64 responses. The majority of respondents were military (90%) versus civilians (10%). There was moderate to high agreement (inter-rater correlation coefficient = 0.93, p < 0.01) for 10 focus areas. The top five focus areas were Personnel/Staffing (mean, 8.03), Resuscitation and Hemorrhage Management (7.49), Pain/Sedation/Anxiety Management (6.96), Operative Interventions (6.9), and Initial Evaluation (6.9). The "Top 10" research priorities included four in Personnel/Staffing, four in Resuscitation/Hemorrhage Management, and three in Operative Interventions. A complete list of the topics/scores will be presented. CONCLUSIONS: This is the first objective ranking of research priorities for combat trauma care. The "Top 10" priorities were all from three focus areas, supporting prioritization of personnel/staffing of austere teams, resuscitation/hemorrhage control, and damage-control interventions. This data will help guide Department of Defense research programs and new areas for prioritized funding of both military and civilian researchers. LEVEL OF EVIDENCE: Study design, level IV.

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