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Maher PJ, Rothman R, Neumar R, Brown J, Sharp W, Cairns C, Kelen GD, Kaji A, Vogel JA, Richardson LD. T32 programs in emergency medicine: A report from the ACEP-SAEM Federal Research Funding Workgroup. Acad Emerg Med 2024. [PMID: 39152536 DOI: 10.1111/acem.15002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 08/01/2024] [Accepted: 08/05/2024] [Indexed: 08/19/2024]
Abstract
Advancing care in Emergency Medicine (EM) requires the development of well-trained researchers, but our specialty has lower amounts of research funding compared to similar medical fields. Increasing the number of pathways available for research training supports the growth of new investigators. To address the need for more EM researchers, the Society of Academic Emergency Medicine and the American College of Emergency Physicians convened a Federal Research Funding Workgroup. Here, we report the workgroup recommendations regarding the creation of Research Training Fellowships using the T32 grant structure sponsored by the National Institutes of Health. After reviewing the history of NIH-grant supported research fellowships in EM, we outline the rationale and describe the core components of T32-supported research fellowships, including program design, fellow evaluation, and recruitment considerations.
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Affiliation(s)
- Patrick J Maher
- Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Richard Rothman
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Robert Neumar
- Department of Emergency Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Jeremy Brown
- Office of Emergency Care Research, National Institutes of Health, Rockville, Maryland, USA
| | - Willard Sharp
- Department of Medicine, Section of Emergency Medicine, University of Chicago School of Medicine, Chicago, Illinois, USA
| | - Charles Cairns
- College of Medicine, Drexel University, Philadelphia, Pennsylvania, USA
| | - Gabor D Kelen
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Amy Kaji
- Department of Emergency Medicine, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California, USA
| | - Jody A Vogel
- Department of Emergency Medicine, Stanford University Medical School, Stanford, California, USA
| | - Lynne D Richardson
- Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Pulcini CD, Barton DJ, Cassara M, Davis JJ, DeMasi SC, Durant EJ, Garg N, Greineder C, McMillian M, Paxton JH, Puskarich MA, Vogel JA, Wong AH, Sharp WW. Assessment of an organizational effort to increase emergency medicine faculty on National Institutes of Health study sections. Acad Emerg Med 2024. [PMID: 39056157 DOI: 10.1111/acem.14993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024]
Affiliation(s)
- Christian D Pulcini
- Departments of Emergency Medicine and Pediatrics, University of Vermont Larner College of Medicine, Burlington, Vermont, USA
| | - David J Barton
- Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Michael Cassara
- Northwell, New Hyde Park, New York, USA
- Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Joshua J Davis
- Vituity, University of Kansas School of Medicine, Kansas College of Osteopathic Medicine, Wichita, Kansas, USA
| | - Stephanie C DeMasi
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | | | - Nidhi Garg
- Northwell Health, Department of Emergency Medicine, South Shore University Hospital, Bayshore, New York, USA
| | - Colin Greineder
- Department of Emergency Medicine, University of Michigan School of Medicine, Ann Arbor, Michigan, USA
| | | | - James H Paxton
- Department of Emergency Medicine, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Michael A Puskarich
- Department of Emergency Medicine, Hennepin Healthcare, Minneapolis, Minnesota, USA
| | - Jody A Vogel
- Department of Emergency Medicine, Stanford University, Palo Alto, California, USA
| | - Ambrose H Wong
- Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Willard W Sharp
- Department of Emergency Medicine, University of Chicago School of Medicine, Chicago, Illinois, USA
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3
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Edwards MR, Lee A, Xu KT, Richman P, Miller M. Industry-sponsored publications in emergency medicine research- 2009 vs 2019. Am J Emerg Med 2022; 61:220-221. [PMID: 35868993 DOI: 10.1016/j.ajem.2022.07.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 07/14/2022] [Indexed: 10/31/2022] Open
Affiliation(s)
- Megan R Edwards
- CHRISTUS Health/Texas A&M Health Science Center, Department of Emergency Medicine, CHRISTUS Spohn Shoreline Hospital, Corpus Christi, TX, United States of America
| | - Albert Lee
- CHRISTUS Health/Texas A&M Health Science Center, Department of Emergency Medicine, CHRISTUS Spohn Shoreline Hospital, Corpus Christi, TX, United States of America
| | - K Tom Xu
- Texas Tech University School of Medicine, Department of Emergency Medicine, Lubbock, TX, United States of America
| | - Peter Richman
- CHRISTUS Health/Texas A&M Health Science Center, Department of Emergency Medicine, CHRISTUS Spohn Shoreline Hospital, Corpus Christi, TX, United States of America.
| | - Michael Miller
- CHRISTUS Health/Texas A&M Health Science Center, Department of Emergency Medicine, CHRISTUS Spohn Shoreline Hospital, Corpus Christi, TX, United States of America
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Chang AK, Lee S, Le R, Ata A, Harland K, Khan A, McMillan M, Mohr N. Influence of Society for Academic Emergency Medicine Foundation's Research Training Grant on postaward academic federal funding. Acad Emerg Med 2022; 29:874-878. [PMID: 35108429 DOI: 10.1111/acem.14456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 01/08/2022] [Accepted: 01/28/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The objective was to measure the impact of the Society for Academic Emergency Medicine Foundation's (SAEMF) Research Training Grant (RTG) by comparing academic success in grant recipients versus non-recipient applicants. Our primary outcome was subsequent federal funding as a principal investigator (PI) or multiple principal investigator (MPI). Our secondary outcomes included subsequent K-award funding, R-series funding, R01 funding, and academic productivity measured by first author peer-reviewed publications. METHODS The authors examined all SAEMF RTG applicants from 2002 through 2019 (n = 109). Data were collected using the National Institutes of Health RePORTER database, a literature search using PubMed, and an online survey sent to all RTG applicants. Relative risks (RRs) with 95% confidence intervals (95% CI) were calculated. RESULTS Over 18 years, 18 of 109 (16.5%) RTG applicants were awarded by SAEMF. Subsequent federal funding as PI or MPI was obtained by 11 of the 18 RTG recipients compared to 29 of the 91 nonrecipients (61% vs. 33%, RR = 1.9; 95% CI = 1.2-3.1). The RTG award was also associated with increased probability of receiving a federal Career Development Award (K-series) (RR 2.0; 95% CI 1.1-3.9) and R-series award (RR 2.0; 95% CI 1.1-3.9) but not an R01 award (RR 2.1; 95% CI 0.8-5.3). The median number of first-authored peer reviewed manuscripts did not differ between RTG award recipients (14, IQR 8,44) and nonrecipients (14, IQR 6,30) (p = 0.5) though RTG recipients had a higher percentage of their publications as a first author (49% vs. 33%, p = 0.04). CONCLUSIONS SAEMF RTG awards were associated with increased probability of future federal funding, including career development awards and R-series awards but not R01 awards. RTG recipients also had a higher percentage of their peer reviewed publications as first author.
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Affiliation(s)
- Andrew K. Chang
- Department of Emergency Medicine Albany Medical College Albany New York USA
| | - Sangil Lee
- Department of Emergency Medicine University of Iowa Carver College of Medicine Iowa City Iowa USA
| | - Rachel Le
- Department of Emergency Medicine Albany Medical College Albany New York USA
| | - Ashar Ata
- Department of Emergency Medicine Albany Medical College Albany New York USA
| | - Kari Harland
- Department of Emergency Medicine University of Iowa Carver College of Medicine Iowa City Iowa USA
| | - Ayesha Khan
- Department of Emergency Medicine Albany Medical College Albany New York USA
| | - Melissa McMillan
- Society for Academic Emergency Medicine Des Plaines Illinois USA
| | - Nick Mohr
- Department of Emergency Medicine University of Iowa Carver College of Medicine Iowa City Iowa USA
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Al-Shatnawi SF, Alzoubi KH, Khasawneh RA, Khabour OF, Almomani BA. Exception from informed consent for biomedical research in emergency settings: A study from Jordan. Heliyon 2021; 7:e08487. [PMID: 34917796 PMCID: PMC8645444 DOI: 10.1016/j.heliyon.2021.e08487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 11/09/2021] [Accepted: 11/23/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Research conduction in emergency settings is of paramount importance to promote knowledge and experiences related to treating acutely ill patients. However, the complexity of situations creates a considerable ethical challenge facing researchers who basically deal with emergent cases. This study aimed to determine attitudes of healthcare providers (HCPs) towards exception from informed consent (EFIC) and enrollment willingness in emergency research in Jordan. METHODS A quantitative research with face-to-face questionnaire was conducted by an interviewer during 6-month period in 2019. Survey measures included items related to EFIC policy and overall willingness of HCPs to participate or support their family members' participation in emergency research. RESULTS A total of 151 HCPs in the emergency departments (EDs) in Jordan was recruited. Positive attitude toward emergency research dominated among participants; about 21.9% of participants reported previous experience in the conduction of emergency research and 12.3% had related publications. Regarding EFIC policy, there was a general consensus of disagreement to most of the examined items. There was a trend for little support of EFIC policy when questioned about the enrollment of family members or public in emergency research, however, the application of EFIC was accepted for self-enrollment of respondents in emergency research. No significant differences (P = 0.37), among participants from different disciplines, were reported regarding the attitudes towards EFIC items or willingness to enroll in emergency research. CONCLUSIONS Generally, HCPs reported an overall positive support to emergency research despite a consensus of disagreement related to EFIC terms. Therefore, it is recommended to pursue future studies to compare well-informed subjects; recruited from well-developed institutions in regard to emergency research potentials; with the present basic attitudinal surveillance in order to dissipate the effect of such confounder and to get better insight of the actual attitudes related to emergency research and EFIC. In addition, efficient multidisciplinary communication channels between researchers and policy makers can lather the way to collaborative research with simultaneous innovative delivery of quality emergency care.
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Affiliation(s)
- Samah F. Al-Shatnawi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, P.O. Box 3030, Irbid, 22110, Jordan,Corresponding author.
| | - Karem H. Alzoubi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, P.O. Box 3030, Irbid, 22110, Jordan
| | - Rawand A. Khasawneh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, P.O. Box 3030, Irbid, 22110, Jordan
| | - Omar F. Khabour
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, P.O. Box 3030, Irbid, 22110, Jordan
| | - Basima A. Almomani
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, P.O. Box 3030, Irbid, 22110, Jordan
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Chai PR, Carreiro S, Chapman BP, Boyer EW, O'Laughlin KN. Federal Funding in Emergency Medicine: Demographics and Perspectives of Awardees. West J Emerg Med 2020; 21:304-312. [PMID: 32191187 PMCID: PMC7081857 DOI: 10.5811/westjem.2019.12.45249] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 12/08/2019] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Emergency physicians face multiple challenges to obtaining federal funding. The objective of this investigation was to describe the demographics of federally-funded emergency physicians and identify key challenges in obtaining funding. METHODS We conducted a retrospective database search of the National Institutes of Health (NIH) Research Portfolio Online Reporting Tool (NIH RePORTER) to collect data regarding the distribution and characteristics of federally-funded grants awarded to emergency medicine (EM) principal investigators between 2010-2017. An electronic survey was then administered to the identified investigators to obtain additional demographic data, and information regarding their career paths, research environment, and perceived barriers to obtaining federal funding. RESULTS We identified 219, corresponding to 51 unique, mentored career development awardees and 105 independent investigators. Sixty-two percent of investigators responded to the electronic survey. Awardees were predominantly White males, although a larger portion of the mentored awardee group was female. Greater than half of respondents reported their mentor to be outside of the field of EM. The most common awarding institution was the National Heart Lung and Blood Institute. Respondents identified barriers in finding adequate mentorship, time to gather preliminary data, and the quality of administrative support. CONCLUSION The last five years have showed a trend toward increasing grants awarded to EM investigators; however, we identified several barriers to funding. Initiatives geared toward support and mentorship of junior faculty, particularly to females, minorities, and those in less heavily funded areas of the country are warranted.
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Affiliation(s)
- Peter R Chai
- Brigham and Women's Hospital, Department of Emergency Medicine, Boston, Massachusetts.,Harvard Medical School, Department of Emergency Medicine, Boston, Massachusetts.,The Fenway Institute, Boston, Massachusetts.,Massachusetts Institute of Technology, The Koch Institute for Integrated Cancer Research, Cambridge, Massachusetts
| | - Stephanie Carreiro
- University of Massachusetts Medical Center, Department of Emergency Medicine, Division of Medical Toxicology, Worcester, Massachusetts
| | - Brittany P Chapman
- University of Massachusetts Medical Center, Department of Emergency Medicine, Division of Medical Toxicology, Worcester, Massachusetts
| | - Edward W Boyer
- Brigham and Women's Hospital, Department of Emergency Medicine, Boston, Massachusetts.,Harvard Medical School, Department of Emergency Medicine, Boston, Massachusetts.,The Fenway Institute, Boston, Massachusetts
| | - Kelli N O'Laughlin
- University of Washington, Department of Emergency Medicine, Seattle, Washington.,University of Washington, Department of Global Health, Seattle, Washington
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Calvocoressi L, Reynolds J, Johnson B, Warzoha MM, Carroll M, Vaca FE, Post L, Dziura J. Quality and Publication of Emergency Medicine Trials Registered in ClinicalTrials.gov. West J Emerg Med 2020; 21:295-303. [PMID: 32191186 PMCID: PMC7081876 DOI: 10.5811/westjem.2019.12.44096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 12/03/2019] [Indexed: 11/19/2022] Open
Abstract
Introduction Promoting emergency medicine (EM) clinical trials research remains a priority. To characterize the status of clinical EM research, this study assessed trial quality, funding source, and publication of EM clinical trials and compared EM and non-EM trials on these key metrics. We also examined the volume of EM trials and their subspecialty areas. Methods We abstracted data from ClinicalTrials.gov (February 2000 – September 2013) and used individual study National Clinical Trial numbers to identify published trials (January 2007 – September 2016). We used descriptive statistics and chi-square tests to examine study characteristics by EM and non-EM status, and Kaplan-Meier curves and log-rank tests to compare time to publication of completed EM and non-EM studies. Results We found 638 interventional EM trials and 59,512 non-EM interventional trials conducted in the United States between February 2000 and September 2013, registered on ClinicalTrials.gov. EM studies were significantly less likely than non-EM studies to be National Institutes of Health-funded or to evaluate a drug or biologic. However, EM studies had significantly larger sample sizes, and were significantly more likely to use randomization and blinding. Overall, 34.3% of EM and 26.0% of non-EM studies were published in peer-reviewed journals. By subspecialty, more EM trials concerned medical/surgical and psychiatric/neurological conditions than trauma. Conclusion Although EM studies were less likely to have received federal or industry funding, and the EM portfolio consisted of only 638 trials over the 14-year study period, the quality of EM trials surpassed that of non-EM trials, based on indices such as randomization and blinding. This novel finding bodes well for the future of clinical EM research, as does the higher proportion of published EM than non-EM trials. Our study also revealed that trauma studies were under-represented among EM studies. Periodic assessment of EM trials with the metrics used here could provide an informative and valuable longitudinal view of progress in clinical EM research.
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Affiliation(s)
- Lisa Calvocoressi
- Yale Center for Analytical Sciences, Yale School of Public Health, New Haven, Connecticut
| | - Jesse Reynolds
- Yale Center for Analytical Sciences, Yale School of Public Health, New Haven, Connecticut
| | - Benjamin Johnson
- Yale Center for Analytical Sciences, Yale School of Public Health, New Haven, Connecticut
| | - Meghan M Warzoha
- Yale Center for Analytical Sciences, Yale School of Public Health, New Haven, Connecticut
| | - Megan Carroll
- Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, Maryland
| | - Federico E Vaca
- Yale School of Medicine, Department of Emergency Medicine, New Haven, Connecticut
| | - Lori Post
- Northwestern University, Feinberg School of Medicine, Department of Emergency Medicine, Chicago, Illinois
| | - James Dziura
- Yale Center for Analytical Sciences, Yale School of Public Health, New Haven, Connecticut.,Yale School of Medicine, Department of Emergency Medicine, New Haven, Connecticut
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Razzak J, Beecroft B, Brown J, Hargarten S, Anand N. Emergency care research as a global health priority: key scientific opportunities and challenges. BMJ Glob Health 2019; 4:e001486. [PMID: 31406602 PMCID: PMC6666807 DOI: 10.1136/bmjgh-2019-001486] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 02/25/2019] [Indexed: 11/03/2022] Open
Abstract
Quality emergency medical care is critical to reducing the burden of disease in low-income and middle-income countries (LMICs) and protecting the health of populations during disasters and epidemics. However, conducting research in emergency care settings in LMIC settings entails unique methodological and operational challenges. Therefore, new approaches and strategies that address these challenges need to be developed and will require increased attention from scientists, academic institutions and the global health research funding community. Research priorities to address emergency care in LMICs have also not been well defined, resulting in limited research output from LMICs. This manuscript frames the efforts of four multidisciplinary working groups, which were established under the auspices of the Fogarty International Center as part of the Collaborative on Enhancing Emergency Care Research in LMICs and serves as an introduction to this series, which identifies challenges and solutions in the context of emergency care research in LMICs. The objective of this introductory paper is to articulate the need for emergency care research in LMICs and underscore its future promise. We present public health arguments for greater investment in emergency care research, identify barriers to develop and conduct research, and present a list of research priorities for community organizations, academic institutions and funding agencies. We conclude that advances in emergency care research will be critical to achieve national and global health targets, such as the Sustainable Development Goals (SDGs), and to ensure that evidence informs how such research is best conducted.
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Affiliation(s)
- Junaid Razzak
- Department of Emergency Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Blythe Beecroft
- Center for Global Health Studies, John E Fogarty International Center, Bethesda, Maryland, USA
| | - Jeremy Brown
- Office of Emergency Care Research, National Institutes of Health, Bethesda, Maryland, USA
| | - Stephen Hargarten
- Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Nalini Anand
- Center for Global Health Studies, John E Fogarty International Center, Bethesda, Maryland, USA
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Newgard CD, Morris CD, Smith L, Cook JNB, Yealy DM, Collins S, Holmes JF, Kuppermann N, Richardson LD, Kimmel S, Becker LB, Scott JD, Lowe RA, Callaway CW, Gowen LK, Baren J, Storrow AB, Vasilevsky N, White M, Zell A. The First National Institutes of Health Institutional Training Program in Emergency Care Research: Productivity and Outcomes. Ann Emerg Med 2018; 72:679-690. [PMID: 30078658 DOI: 10.1016/j.annemergmed.2018.06.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 05/29/2018] [Accepted: 06/11/2018] [Indexed: 10/28/2022]
Abstract
STUDY OBJECTIVE We assess the productivity, outcomes, and experiences of participants in the National Institutes of Health/National Heart, Lung, and Blood Institute-funded K12 institutional research training programs in emergency care research. METHODS We used a mixed-methods study design to evaluate the 6 K12 programs, including 2 surveys, participant interviews, scholar publications, grant submissions, and funded grants. The training program lasted from July 1, 2011, through June 30, 2017. We tracked scholars for a minimum of 3 years and up to 5 years, beginning with date of entry into the program. We interviewed program participants by telephone using open-ended prompts. RESULTS There were 94 participants, including 43 faculty scholars, 13 principal investigators, 30 non-principal investigator primary mentors, and 8 program administrators. The survey had a 74% overall response rate, including 95% of scholars. On entry to the program, scholars were aged a median of 37 years (interquartile range [IQR] 34 to 40 years), with 16 women (37%), and represented 11 disciplines. Of the 43 scholars, 40 (93%) submitted a career development award or research project grant during or after the program; 26 (60%) have secured independent funding as of August 1, 2017. Starting with date of entry into the program, the median time to grant submission was 19 months (IQR 11 to 27 months) and time to funding was 33 months (IQR 27 to 39 months). Cumulative median publications per scholar increased from 7 (IQR 4 to 15.5) at program entry to 21 (IQR 11 to 33.5) in the first post-K12 year. We conducted 57 semistructured interviews and identified 7 primary themes. CONCLUSION This training program produced 43 interdisciplinary investigators in emergency care research, with demonstrated productivity in grant funding and publications.
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Affiliation(s)
- Craig D Newgard
- Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine, Oregon Health & Science University, Portland, OR.
| | - Cynthia D Morris
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR; Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland, OR
| | - Lindsey Smith
- Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland, OR
| | - Jennifer N B Cook
- Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine, Oregon Health & Science University, Portland, OR
| | - Donald M Yealy
- Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Sean Collins
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - James F Holmes
- Department of Emergency Medicine, UC Davis Health, Sacramento, CA
| | | | - Lynne D Richardson
- Department of Emergency Medicine, Department of Population Health Science & Policy, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Stephen Kimmel
- Departments of Medicine and of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, PA
| | - Lance B Becker
- Department of Emergency Medicine, Zucker School of Medicine at Hofsra Northwell, Manhasset, NY
| | - Jane D Scott
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD
| | - Robert A Lowe
- Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine, Oregon Health & Science University, Portland, OR; Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR
| | - Clifton W Callaway
- Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, PA
| | - L Kris Gowen
- Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland, OR
| | - Jill Baren
- Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA
| | - Alan B Storrow
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Nicole Vasilevsky
- Ontology Development Group, Library, Oregon Health & Science University, Portland, OR
| | - Marijane White
- Ontology Development Group, Library, Oregon Health & Science University, Portland, OR
| | - Adrienne Zell
- Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland, OR
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10
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Mumma BE, Chang AM, Kea B, Ranney ML. Career Development Awards in Emergency Medicine: Resources and Challenges. Acad Emerg Med 2017; 24:855-863. [PMID: 28342177 DOI: 10.1111/acem.13189] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 03/10/2017] [Accepted: 03/18/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVES In the United States, emergency medicine (EM) researchers hold proportionately fewer federal career development awards than researchers in other specialties. Others hypothesize that this deficit may partly be attributed to lack of mentors, departmental resources, and qualified applicants. Our objectives were to examine the association between departmental and institutional resources and career development awards and to describe the barriers to conducting research and btaining grants in EM. METHODS We conducted an online, cross-sectional survey study of vice chairs for research and research directors at academic emergency departments in the United States in January and February 2016. Participants provided quantitative information regarding their department's demographics, available research resources, number of funded independent investigators, and number of career development awards. They were also asked about the perceived adequacy of departmental and institutional resources and perceived barriers to research and grant success. Data were analyzed using descriptive statistics and multivariable linear regression, as appropriate. RESULTS Of 178 eligible participants, 103 (58%) completed the survey. Most departments reported some infrastructure for research and grant submission, including research coordinator(s) (n = 75/99; 76%, 95% confidence interval [CI] = 66%-84%), research associates (69/99; 70%, 95% CI = 60%-79%), and administrative/secretarial research support (79/101; 78%, 95% CI = 69%-86%). The majority of departments (56/103; 49%, 95% CI = 44%-64%) had no R01-funded researchers, and only 15 (15%, 95% CI = 8%-23%) had three or more R01-funded researchers. The most frequently reported challenge to junior faculty applying for grants was low motivation for applying (62/103; 60%, 95% CI = 50%-70%), followed closely by insufficient mentorship (50/103; 49%, 95% CI = 39%-59%) and discouragement from low funding rates (50/103; 49%, 95% CI = 39%-59%). In the multivariable model, only the number of departmental R-level-funded researchers was associated with the number of departmental career development awards (coefficient = 0.75, 95% CI = 0.39-1.11; R2 = 0.57). CONCLUSIONS While more multiple departmental and institutional resources correlated with a greater number of funded career development awards, the single greatest predictor was the number of R-level-funded researchers in the department. Low motivation and insufficient mentorship were the most frequently reported barriers to junior faculty applying for career development awards. Further studies are needed to describe junior faculty perspectives on these issues and to explore strategies for overcoming these barriers.
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Affiliation(s)
- Bryn E. Mumma
- Department of Emergency Medicine; University of California Davis; Sacramento CA
| | - Anna Marie Chang
- Department of Emergency Medicine; Thomas Jefferson University; Philadelphia PA
| | - Bory Kea
- Department of Emergency Medicine; Oregon Health & Sciences University; Portland OR
| | - Megan L. Ranney
- Department of Emergency Medicine; Alpert Medical School; Brown University; Providence RI
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11
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Abstract
Introduction Over 25 years, emergency medicine in the United States has amassed a large evidence base that has been systematically assessed and interpreted through ACEP Clinical Policies. While not previously studied in emergency medicine, prior work has shown that nearly half of all recommendations in medical specialty practice guidelines may be based on limited or inconclusive evidence. We sought to describe the proportion of clinical practice guideline recommendations in Emergency Medicine that are based upon expert opinion and low level evidence. Methods Systematic review of clinical practice guidelines (Clinical Policies) published by the American College of Emergency Physicians from January 1990 to January 2016. Standardized data were abstracted from each Clinical Policy including the number and level of recommendations as well as the reported class of evidence. Primary outcomes were the proportion of Level C equivalent recommendations and Class III equivalent evidence. The primary analysis was limited to current Clinical Policies, while secondary analysis included all Clinical Policies. Results A total of 54 Clinical Policies including 421 recommendations and 2801 cited references, with an average of 7.8 recommendations and 52 references per guideline were included. Of 19 current Clinical Policies, 13 of 141 (9.2%) recommendations were Level A, 57 (40.4%) Level B, and 71 (50.4%) Level C. Of 845 references in current Clinical Policies, 67 (7.9%) were Class I, 272 (32.3%) Class II, and 506 (59.9%) Class III equivalent. Among all Clinical Policies, 200 (47.5%) recommendations were Level C equivalent, and 1371 (48.9%) of references were Class III equivalent. Conclusions Emergency medicine clinical practice guidelines are largely based on lower classes of evidence and a majority of recommendations are expert opinion based. Emergency medicine appears to suffer from an evidence gap that should be prioritized in the national research agenda and considered by policymakers prior to developing future quality standards.
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National Institutes of Health Funding of Emergency Care Research: Feast or Famine? Ann Emerg Med 2016; 68:172-3. [PMID: 27157454 DOI: 10.1016/j.annemergmed.2016.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Indexed: 11/21/2022]
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