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Review
. 2024 Apr;50(2):367-382.
doi: 10.1007/s00068-023-02441-3. Epub 2024 Feb 27.

European society for trauma and emergency surgery member-identified research priorities in emergency surgery: a roadmap for future clinical research opportunities

Gary Alan Bass  1   2   3 , Lewis Jay Kaplan  4   5 , Christine Gaarder  6 , Raul Coimbra  7   8   9 , Nathan John Klingensmith  4 , Hayato Kurihara  10   11 , Mauro Zago  12 , Stefano Piero Bernardo Cioffi  13 , Shahin Mohseni  14   15   16 , Michael Sugrue  17 , Matti Tolonen  18 , Cristina Rey Valcarcel  19 , Jonathan Tilsed  20 , Frank Hildebrand  21 , Ingo Marzi  22
Affiliations
Review

European society for trauma and emergency surgery member-identified research priorities in emergency surgery: a roadmap for future clinical research opportunities

Gary Alan Bass et al. Eur J Trauma Emerg Surg. 2024 Apr.

Erratum in

Abstract

Background: European Society for Trauma and Emergency Surgery (ESTES) is the European community of clinicians providing care to the injured and critically ill surgical patient. ESTES has several interlinked missions - (1) the promotion of optimal emergency surgical care through networked advocacy, (2) promulgation of relevant clinical cognitive and technical skills, and (3) the advancement of scientific inquiry that closes knowledge gaps, iteratively improves upon surgical and perioperative practice, and guides decision-making rooted in scientific evidence. Faced with multitudinous opportunities for clinical research, ESTES undertook an exercise to determine member priorities for surgical research in the short-to-medium term; these research priorities were presented to a panel of experts to inform a 'road map' narrative review which anchored these research priorities in the contemporary surgical literature.

Methods: Individual ESTES members in active emergency surgery practice were polled as a representative sample of end-users and were asked to rank potential areas of future research according to their personal perceptions of priority. Using the modified eDelphi method, an invited panel of ESTES-associated experts in academic emergency surgery then crafted a narrative review highlighting potential research priorities for the Society.

Results: Seventy-two responding ESTES members from 23 countries provided feedback to guide the modified eDelphi expert consensus narrative review. Experts then crafted evidence-based mini-reviews highlighting knowledge gaps and areas of interest for future clinical research in emergency surgery: timing of surgery, inter-hospital transfer, diagnostic imaging in emergency surgery, the role of minimally-invasive surgical techniques and Enhanced Recovery After Surgery (ERAS) protocols, patient-reported outcome measures, risk-stratification methods, disparities in access to care, geriatric outcomes, data registry and snapshot audit evaluations, emerging technologies interrogation, and the delivery and benchmarking of emergency surgical training.

Conclusions: This manuscript presents the priorities for future clinical research in academic emergency surgery as determined by a sample of the membership of ESTES. While the precise basis for prioritization was not evident, it may be anchored in disease prevalence, controversy around aspects of current patient care, or indeed the identification of a knowledge gap. These expert-crafted evidence-based mini-reviews provide useful insights that may guide the direction of future academic emergency surgery research efforts.

Keywords: Delphi Technique; Diagnosis; Emergency Surgery; Implementation Science; Research; Treatment.

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Conflict of interest statement

Gary A Bass is the Chair of Research for the European Society of Trauma and Emergency Surgery (ESTES) and is a Section Editor for the European Journal of Trauma and Emergency Surgery (EJTES). Lewis J. Kaplan is a past-President of the Society of Critical Care Medicine (2020–2021) and serves on the editorial board of Critical Care Medicine. As an employee of the Veterans Health Administration, Dr. Kaplan’s opinions do not reflect the opinions or policies of the VHA. Christine Gaarder is President-Elect of ESTES. Raul Coimbra is Editor-in-Chief of the Journal of Trauma and Acute Care Surgery. Hayato Kurihara is Immediate Past-President of ESTES. Shahin Mohseni is Chair of the Visceral Trauma Section of ESTES. Christine Rey Valcarel is Chair of the ESTES Advisory Council. Jonathan Tilsed is Vice-President of ESTES. Frank Hildebrand is President of ESTES. Ingo Marzi is Editor-in-Chief of EJTES.

Figures

Fig. 1
Fig. 1
Potential knowledge and research gaps in Emergency General Surgery, identified by ESTES membership for future research prioritization: timing of surgery, pre-hospital care and inter-hospital transfer, diagnostic imaging in emergency surgery, the role of minimally-invasive surgical techniques and Enhanced Recovery After Surgery (ERAS) protocols, patient-reported outcome measures, risk-stratification methods, disparities in access to care, geriatric outcomes, data registry and snapshot audit evaluations, emerging technologies interrogation, and the delivery and benchmarking of emergency surgical training
Fig. 2
Fig. 2
Snapshot audits conform to a similar structure: being time-bound, non-interventional, and multi-institutional. A successful diverse steering committee will leverage expertise that includes clinical care and data science, coupled with librarian services. Pre-published protocols (with specified aims and analyses) greatly aids site recruitment. Mentored trainee involvement at collaborating sites should be encouraged through manuscript contributorship. Current funding principally flows from medical professional organizations. The snapshot audit approach to assessing current care provides insights into care delivery, outcomes, and guideline compliance while generating testable hypotheses
See this image and copyright information in PMC

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