National research agenda for postcrash care.
The journal of trauma and acute care surgery · 2025-03-28 · Qualitative study
Abstract
BACKGROUND: In 2021, 42,939 people died in US traffic crashes, and 40% of the dead were alive when first responders arrived. The US Department of Transportation recently set a target of zero roadway fatalities and identified post-crash care as essential to achieving this goal. While there are research agendas for violent injury, suicide, and other areas, this is the first effort to define a research agenda for post-crash care to help meet the new national goal of zero roadway fatalities. METHODS: This original research study consisted of a four-round modified Delphi process culminating in an in-person conference of 27 subject matter experts in Los Angeles for Rounds 3 and 4 on May 7 to 8, 2024. In Round 1, participants prioritized 10 themes from a list of 21 generated by the planning committee. In Round 2, participants generated at least one question per theme for at least five of the 10 themes. This yielded a minimum of five questions per participant. In Round 3, participants prioritized questions in small groups and generated new questions that arose during discussion. In Round 4, participants finalized high-priority questions in a large group. RESULTS: Participants prioritized the following10 themes: system issues; policy; research infrastructure; novel equipment, treatment, or medications; resuscitation; healthcare disparities; vehicle technology; safety; prehospital medical technology; and workforce issues. Rounds 2 to 4 yielded a total of 74 high-priority questions in areas as diverse as universal patient tracking, improved triage, use of freeze-dried plasma, drone-delivered treatment, and automatic crash notification. CONCLUSION: This study developed high-priority research questions to optimize post-crash care. Investigators, professional societies, policy makers, and funding agencies can use this agenda to inform future research and funding priorities to achieve the goal of zero roadway fatalities. LEVEL OF EVIDENCE: Prognostic and Epidemiological; Level V.