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The development of novel diagnostic and therapeutic strategies will require new and substantive research into underlying mechanisms of disease and injury. In order to optimize value in the development of emergency therapeutic strategies, mechanistic investigations must pay particular attention to the sequence and timing of pathophysiological events. Furthermore, the effective translation of therapies developed in preclinical models of timesensitive disease states to the clinical research setting will require the enrollment of research subjects early in their clinical course when such therapies are most likely to be effective. RESEARCH AGENDAS FOR EMERGENCY CARE Emergency care research has been the subject of two important research agenda setting efforts. The Macy Foundation reports suggested these specific recommendations for the further evolution of emergency medicine research: • Enhance support for basic, clinical, and health services research pertinent to emergency medicine practice. • Promote collaborative and interdisciplinary research within and across traditional institutional boundaries. • Develop new systems to manage clinical information. • Develop new methods to assess the outcomes of emergency care. • Seek and develop increased funding sources for emergency medicine research.
More recently, the Institute of Medicine Committee on the Future of Emergency Care in the United States Health System convened and identified a crisis in emergency care in the United States, including a need to enhance the research base for emergency care. As a result, the National Institutes of Health (NIH) formed an NIH Task Force on Research in Emergency Medicine to enhance NIH support for emergency care research. Members of the NIH Task Force and academic leaders in emergency care participated in three Roundtable discussions to prioritize current opportunities for enhancing and conducting emergency care research. The Roundtables were focused on: (a) neurological and psychiatric emergencies; (b) medical and surgical emergencies; and (c) emergency trauma. The objectives of these NIH Roundtables were to identify key research questions essential to advancing the scientific underpinnings of emergency care and to discuss the barriers and best means to advance research by exploring the role of research networks and collaboration between NIH and the emergency care community. The key themes of each of the three Roundtable reports are highlighted.