NIH Roundtable on Opportunities to Advance Research on Neurologic and Psychiatric Emergencies

被引：58

作者：

D'Onofrio, Gail ^{[1
]}

Jauch, Edward ^{[2
]}

Jagoda, Andrew ^{[3
]}

Allen, Michael H. ^{[4
]}

Anglin, Deirdre ^{[5
]}

Barsan, William G. ^{[6
]}

Berger, Rachel P. ^{[7
]}

Bobrow, Bentley J. ^{[8
]}

Boudreaux, Edwin D. ^{[9
]}

Bushnell, Cheryl ^{[10
]}

Chan, Yu-Feng ^{[3
]}

Currier, Glenn ^{[11
]}

Eggly, Susan ^{[12
]}

Ichord, Rebecca ^{[13
]}

Larkin, Gregory L. ^{[1
]}

Laskowitz, Daniel ^{[14
]}

Neumar, Robert W. ^{[13
]}

Newman-Toker, David E. ^{[15
]}

Quinn, James ^{[16
]}

Shear, Katherine ^{[17
]}

Todd, Knox H. ^{[18
]}

Zatzick, Douglas ^{[19
]}

机构：

[1] Yale Univ, Sch Med, New Haven, CT 06520 USA

[2] Med Univ S Carolina, Charleston, SC USA

[3] Mt Sinai Sch Med, New York, NY USA

[4] Univ Colorado Denver, Denver, CO USA

[5] Univ So Calif, Keck Sch Med, Los Angeles, CA 90033 USA

[6] Univ Michigan, Ann Arbor, MI 48109 USA

[7] Univ Pittsburgh, Sch Med, Pittsburgh, PA 15260 USA

[8] Mayo Clin, Coll Med, Rochester, MN 55905 USA

[9] Cooper Univ Hosp, Camden, NJ USA

[10] Wake Forest Univ, Winston Salem, NC 27109 USA

[11] Univ Rochester, Med Ctr, Rochester, NY 14627 USA

[12] Wayne State Univ, Sch Med, Detroit, MI 48202 USA

[13] Univ Penn, Sch Med, Philadelphia, PA 19104 USA

[14] Duke Univ, Med Ctr, Durham, NC 27706 USA

[15] Johns Hopkins Univ, Baltimore, MD 21218 USA

[16] Stanford Univ, Stanford, CA 94305 USA

[17] Columbia Univ, New York, NY 10027 USA

[18] Albert Einstein Med Ctr, Philadelphia, PA 19141 USA

[19] Univ Washington, Sch Med, Seattle, WA 98195 USA

来源：

ANNALS OF EMERGENCY MEDICINE | 2010年 / 56卷 / 05期

关键词：

HOSPITAL CARDIAC-ARREST; CLINICAL POLICY; DIAGNOSTIC-TEST; CARE; US; STROKE; INTERVENTION; DEPARTMENTS; MANAGEMENT; MEDICINE;

D O I：

10.1016/j.annemergmed.2010.06.562

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Study objective: The Institute of Medicine Committee on the Future of Emergency Care in the United States Health System (2003) identified a need to enhance the research base for emergency care. As a result, a National Institutes of Health (NIH) Task Force on Research in Emergency Medicine was formed to enhance NIH support for emergency care research. Members of the NIH Task Force and academic leaders in emergency care participated in 3 Roundtable discussions to prioritize current opportunities for enhancing and conducting emergency care research. We identify key research questions essential to advancing the science of emergency care and discuss the barriers and strategies to advance research by exploring the collaboration between NIH and the emergency care community. Methods: Experts from emergency medicine, neurology, psychiatry, and public health assembled to review critical,areas in need of investigation, current gaps in knowledge, barriers, and opportunities. Neurologic emergencies included cerebral resuscitation, pain, stroke, syncope, traumatic brain injury, and pregnancy. Mental health topics included suicide, agitation and delirium, substances, posttraumatic stress, violence, and bereavement. Results: Presentations and group discussion firmly established the need for translational research to bring basic science concepts into the clinical arena. A coordinated continuum of the health care system that ensures rapid identification and stabilization and extends through discharge is necessary to maximize overall patient outcomes. There is a paucity of well-designed, focused research on diagnostic testing, clinical decisionmaking, and treatments in the emergency setting. Barriers include the limited number of experienced researchers in emergency medicine, limited dedicated research funding, and difficulties of conducting research in chaotic emergency environments stressed by crowding and limited resources. Several themes emerged during the course of the roundtable discussion, including the need for development of (1) a research infrastructure for the rapid identification, consent, and tracking of research subjects that incorporates innovative informatics technologies, essential for future research; (2) diagnostic strategies and tools necessary to understand key populations and the process of medical decisionmaking, including the investigation of the pathobiology of symptoms and symptom-oriented therapies; (3) collaborative research networks to provide unique opportunities to form partnerships, leverage patient cohorts and clinical and financial resources, and share data; (4) formal research training programs integral for creating new knowledge and advancing the science and practice of emergency medicine; and (5) recognit on that emergency care is part of an integrated system from emergency medical services dispatch to discharge. The NIH Roundtable "Opportunities to Advance Research on Neurological and Psychiatric Emergencies" created a framework to guide future emergency medicine-based research initiatives. Conclusion: Emergency departments provide the portal of access to the health care system for most patients with acute neurologic and psychiatric illness. Emergency physicians and colleagues are primed to investigate neurologic and psychiatric emergencies that will directly improve the delivery of care and patient outcomes. [Ann Emerg Med. 2010;56:551-564.]

引用

页码：551 / 564

页数：14

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