NATIONAL EMS RESEARCH AGENDA Published: December 31, 2001 Supported by the National Highway Traffic Safety Administration, Department of Transportation and the Maternal and Child Health Bureau, Health Resources Services Administration, Department of Health and Human Services Grant: DTN 22-99-H-05100 National EMS Research Agenda TABLE OF CONTENTS Abstract ......................................................................................................................................................................4 Dedication...................................................................................................................................................................4 Preface........................................................................................................................................................................5 Process ...................................................................................................................................................................5 Similar Efforts .......................................................................................................................................................5 Definition of EMS for this Document ........................................................................................................................6 Federal Agencies Can Help Advance EMS Research ................................................................................................6 Executive Summary....................................................................................................................................................7 Develop Researchers..............................................................................................................................................7 Facilitate Collaboration..........................................................................................................................................7 Establish a Reliable Funding Stream .....................................................................................................................8 Establish Alternative Funding Sources..................................................................................................................8 Recognize The Need for EMS Research................................................................................................................9 View Research as Necessary for the Improvement of Patient Care.......................................................................9 Create Reliable Information Systems ....................................................................................................................9 Enhance Ethical Approaches to Research............................................................................................................10 Conclusion ...........................................................................................................................................................10 Introduction ..............................................................................................................................................................11 EMS Impact.........................................................................................................................................................11 Is EMS Cost-effective?........................................................................................................................................11 Need for Outcome Measurement .........................................................................................................................11 Organized Research Effort Needed......................................................................................................................12 History of EMS Research .........................................................................................................................................13 Federal Involvement in EMS Begins...................................................................................................................13 Beginning of EMS Research................................................................................................................................13 A Case Study In EMS Research ..........................................................................................................................14 The Present State of EMS Research .........................................................................................................................15 Appeals for Advancement....................................................................................................................................15 Peer Review Journals...........................................................................................................................................15 Methodological Constraints and Concerns ..........................................................................................................15 Current Literature in EMS ...................................................................................................................................15 Research Domains ...............................................................................................................................................17 Clinical Research ............................................................................................................................................18 Systems Research............................................................................................................................................18 Education ........................................................................................................................................................18 Overcoming the Barriers to EMS Research..............................................................................................................19 Primary Barriers: Developing Researchers..........................................................................................................19 Primary Barriers: Funding ...................................................................................................................................20 Secondary Barriers: Recognizing the Need for EMS Research...........................................................................22 The Culture of EMS........................................................................................................................................22 EMS Systems ..................................................................................................................................................23 EMS Education ...............................................................................................................................................23 The Public and Policy Makers ........................................................................................................................24 EMS Professionals ..........................................................................................................................................24 Secondary Barriers: Information Systems ...........................................................................................................24 Data Definitions ..............................................................................................................................................24 Hardware and Software Infrastructure ............................................................................................................25 Data Set Linkages ...........................................................................................................................................25 Statistical Implications of Large Databases ....................................................................................................26 Secondary Barriers: Ethical Concerns .................................................................................................................26 Principles.........................................................................................................................................................26 Informed Consent............................................................................................................................................27 IRBs and EMS Research.................................................................................................................................28 Valuing Individual Autonomy ........................................................................................................................28 www.ResearchAgenda.org 2 National EMS Research Agenda Summary...................................................................................................................................................................30 Appendix A: The National EMS Research Agenda Writing Team ..........................................................................31 Appendix B: Organizations Invited to Participate in the National Review Team ....................................................32 Appendix C: Ethical Standards and IRB Requirements ...........................................................................................33 Appendix D ..............................................................................................................................................................34