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project on the future of emergency medicine highlighted the need to develop a research agenda for emergency medicine. Follow-up projects (2, 3) suggested that emergency medicine research efforts be prioritized toward: 1. Elucidation basic mechanisms, pathophysiology, and treatments of life-threatening conditions. 2. Perfection of techniques, modalities, and technologies to rapidly diagnose and manage ED patients, with particular emphasis on atypical or undifferentiated signs and symptoms. 3. Definition of the optimal role and configuration of emergency care services in a population-based system of care. RESEARCH DIRECTIONS IN EMERGENCY MEDICINE REPORT ON OUTCOMES RESEARCH Outcomes research was identified as a major area of need in emergency care and there was a call for the development of new methods to assess acute care outcomes (3). In addition, the following were recommended as focus areas for outcomes studies in emergency medicine: 1. Contribution of the emergency care–related services to the overall episode of care. 2. Use of epidemiologically based methods to identify populations at risk for emergency events. 3. Identification of disease-specific acute care outcome measures. 4. New methods to assess the effect of acute interventions on quality of life. 5. Measurement tools to assess the risk-adjustment of acute care patients. 6. Management tools to evaluate the impact of the marginal costs of emergency medical care. 7. Methods to rapidly and effectively communicate diagnostic and treatment choices to patients having acute events. The Macy Research Directions in Emergency Medicine Reports also highlighted research funding strategies, the value of research collaborations, developing the emergency medicine research infrastructure and database and informational management strategies (2–4). RESEARCH PRIORITIES IN EMERGENCY MEDICINE 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 (5). 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 (6–8). 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. While the key themes and research priorities of the three Roundtable reports are highlighted in Chapter 1 (What Is Emergency Care Research?), the overarching messages of the NIH Roundtable reports included (6–8): CHAPTER 2 — HOW TO PICK AN EMERGENCY MEDICINE RESEARCH TOPIC 9 • Emergency care research is characterized by focus on the timing, sequence, and time sensitivity of disease processes and treatment effects. • Rapidly identifying the phenotype of patients manifesting a specific disease process and the mechanistic reasons for heterogeneity in outcome are important challenges in emergency care research. • Need to elucidate the timing, sequence, and duration of causal molecular and cellular events involved in time-critical illnesses and injuries, and the development of treatments capable of halting or reversing them. • Need for novel experimental models of emergency conditions. • Understand regional differences in outcome for the same emergency disease processes. There is a need to rapidly characterize, or phenotype, emergency patients on the basis of the severity and acuity of their disease state (6–8). Thus, a priority in emergency care research is the development and testing of rapid diagnostic strategies. In addition, there is a need to develop and test therapeutic strategies for patients with emergency conditions. The NIH Roundtable reports are a valuable source for research topics as they provide specific guidance on which emergency conditions have been prioritized in federal research agendas. TURNING THE TOPIC INTO A PROJECT Once a research area of interest has been identified, it is important to evolve the topic into a successful research project. For novice and junior investigators, it will be important to identify a research mentor who has expertise in research design, a record of productivity in publications and grant funding, and interest in mentoring evolving investigators (see Chapter 3 [Why Do I Need a Mentor?]). In our experience, initial projects for novice emergency medicine investigators usually focus on conditions involving: • Life-threatening conditions (severe distress or disease) • Time-sensitive conditions (characterized by minutes, hours and days) • Common disease conditions (undifferentiated signs and symptoms; large populations) • Conditions with defined follow-up time-frames 

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