High Priority Traumatic Brain Injury Science: Analysis of the National Trauma Research Action Plan.

INTRODUCTION

The National Trauma Research Action Plan convened 11 topic area panels to complete consensus-driven Delphi surveys to identify high priority trauma research questions. The Neurotrauma Panel identified questions relating to interventional and comparative effectiveness trials in severe traumatic brain injury (sTBI) critical care as highest priority. This qualitative secondary analysis aims to translate results across several Delphi panels into potential studies in sTBI critical care.

METHODS

High priority consensus research questions related to sTBI in the critical phase of care (ranked >6.5 on a 1-9 Likert scale) were screened from the Neurotrauma, Critical Care, Geriatric, and Long-Term Outcomes Panels results. Using grounded theory, two reviewers inductively open-coded questions independently and then refined them for consensus. A similar approach was used to recategorize questions into codes. Each code was then characterized into research project(s) with an aim, design, exposure(s), and outcome(s).

RESULTS

Among 376 high-priority questions reaching consensus, 55 related to sTBI critical care. Twelve projects emerged across eight consensus thematic codes: biomarkers (1 project, average priority score/range 6.92), imaging (1, 6.84), prognostication (1, 6.77), novel neuromonitoring (3, 6.61-6.77), intracranial pressure/cerebral perfusion pressure (2, 6.67-6.76), coagulopathy (2, 6.66-6.74), early rehabilitation (1, 6.67), and pharmacologic intervention (1, 6.66).

CONCLUSIONS

This National Trauma Research Action Plan secondary analysis identified several high-priority research projects in sTBI critical care. While some questions are being addressed in ongoing trials, investigators and funding agencies should consider using these consensus-driven Delphi panel results and subsequent analyses to prioritize future research proposals.