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training of emergency care investigators; (b) development of emergency care clinical research networks; (c) emergency care–specific federal research initiatives; (d) involvement of emergency specialists in grant review and research advisory processes; (e) support learn-phase and adaptive clinical trials; and (f) performance of research to address unique ethical and regulatory issues in emergency research. CONCLUSIONS Emergency medicine research involves the study of time-sensitive, severe disease conditions that impact broad populations. The hypothesis that time makes a difference has been proven in multiple emergency conditions. These successes have led to the development of a compelling research agenda for emergency care. Enhancement of the research basis for emergency care will require progress in mechanistic, translational, and clinical domains as well as collaboration of investigators across traditional clinical and scientific disciplines. In addition, emergency care researchers will need to overcome limitations in available infrastructure, research training, and access to emergency patient populations (2, 8, 9). 6 CHAPTER 1 — WHAT IS ACUTE AND EMERGENCY CARE RESEARCH? REFERENCES 1. Josiah Macy Jr Foundation. The role of emergency medicine in the future of American medical care. Ann Emerg Med. 1995;25:230-233. 2. Kaji AH, Lewis RL, Beavers-May T, et al. Summary of NIH Medical-Surgical Emergency Research Roundtable. Ann Emerg Med. 2010;56(5):522-537. 3. Aghababian RV, Barsan WG, Bickell WH, et al. Research directions in emergency medicine. Ann Emerg Med. 1996;27:339-342. 4. Cairns CB, Garrison HG, Hedges JR, et al: Development of new methods to assess the outcomes of emergency care. Acad Emerg Med. 1998;5:157-161. 5. Neumar RM. The Zerhouni challenge: defining the fundamental hypothesis of emergency care research. Acad Emerg Med. 2007;49:696-697. 6. Courtney DM, Neumar RW, Vekatesth AK, et al. Unique characteristics of emergency care research: scope, populations, and infrastructure. Acad Emerg Med. 2009;16:990-994. 7. Institute of Medicine, Committee on the Future of Emergency Care in the U.S. Health System. Hospital Based Emergency Care: At the Breaking Point. Washington, DC: National Academies Press; 2006. 8. Cairns CB, Maier RV, Adeoye O, et al. NIH Roundtable on Emergency Trauma Research. Acad Emerg Med. 2010;56(5):538-551. 9. D’Onofrio G, Jauch E, Jagoda A, et al. NIH Roundtable on Opportunities to Advance Research on Neurologic and Psychiatric Emergencies. Acad Emerg Med. 2010;56:551-564. 10. Kellerman AK: Consilience [editorial on NIH Roundtables on Emergency Care]. Acad Emerg Med. 2010;56:551-564. TABLE 1-2. Key Themes from the NIH Roundtable Reports on Emergency Care Research (2, 8, 9) • Emergency care research focuses on the timing, severity, and acute sensitivity of disease and treatment • Rapidly identifying the phenotype and genotype of patients for a specific disease and mechanistic reasons for heterogenieity • Elucidate the timing, sequence, and duration of causal molecular and cellular events involved in time-critical illnesses and injuries • Treatments capable of halting or reversing them • Emergency care is an integrated system from emergency medical services dispatch to discharge • Understand regional differences in outcome for the same disease processes CHAPTER 2 — HOW TO PICK AN EMERGENCY MEDICINE RESEARCH TOPIC 7 HOW TO PICK AN EMERGENCY MEDICINE RESEARCH TOPIC Charles B. Cairns, MD, FACEP Vikhyat S. Bebarta, MD, FACEP Edward A. Panacek, MD, MPH, FACEP IMPORTANCE OF THE RESEARCH TOPIC A key challenge to having a successful research project, one suitable for publication or grant funding, is the identification of an interesting research topic and the design of a research approach that will be able to answer the question of interest. Many clinically based investigators find a research topic by examining clinical practice looking for important clinical challenges. Other approaches include inspiration from the clinical or scientific literature and attending conferences or lectures both within and outside of emergency medicine. Frankly, most successful researchers have learned their topic selection and research skills from a research mentor as part of an integrated research training program. All of these mentors share some combination of the attributes of curiosity, energy, innovation, scholarship, patience, and intelligence. This chapter emphasizes a practical approach to the identification of research topics of importance to emergency medicine researchers and to the development and communication of research projects competitive for publication and grant funding. BROAD RESEARCH AREAS IN EMERGENCY MEDICINE Emergency medicine is the only medical care resource that offers both immediacy and universality of service. Thus, emergency medicine is concerned with clinical conditions that are time-dependent, carry high morbidity or mortality, involve diagnostic uncertainty, and affect traditionally underserved populations (1, 2). Thus, emergency medicine researchers have a wide array of potential areas of study. EMERGENCY CARE RESEARCH – A PRIMER CHAPTER 2 8 CHAPTER 2 — HOW TO PICK AN EMERGENCY MEDICINE RESEARCH TOPIC The Macy Foundation 

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