Global Health and Emergency Care: Overcoming Clinical Research Barriers

Published on Apr 1, 2017in Academic Emergency Medicine2.96
· DOI :10.1111/acem.13142
Adam C. Levine14
Estimated H-index: 14
(Brown University),
Meagan A. Barry6
Estimated H-index: 6
(BCM: Baylor College of Medicine)
+ 4 AuthorsBhakti Hansoti2
Estimated H-index: 2
(JHUSOM: Johns Hopkins University School of Medicine)
Objectives There are many barriers impeding the conduct of high-quality emergency care research, particularly in low- and middle-income countries. Several of these barriers were originally outlined in 2013 as part of the Academic Emergency Medicine Global Health and Emergency Care Consensus Conference. This paper seeks to establish a broader consensus on the barriers to emergency care research globally and proposes a comprehensive array of new recommendations to overcome these barriers. Methods An electronic survey was conducted of a purposive sample of Global Emergency Medicine research experts from around the world to describe the major challenges and solutions to conducting emergency care research in low resource settings and rank them by importance. The Global Emergency Medicine Think Tank Clinical Research Working Group at the Society for Academic Emergency Medicine 2016 Annual Meeting utilized a modified Delphi technique for consensus-based decision making to categorize and expand upon these barriers and develop a comprehensive array of proposed solutions. Results The working group identified four broad categories of barriers to conducting emergency care research globally, including 1) the limited availability of research personnel, particularly those with prior research training; 2) logistical barriers and lack of standardization of data collection; 3) ethical barriers to conducting research in resource-limited settings, particularly when no local institutional review board is available; and 4) the relative dearth of funding for global emergency care research. Proposed solutions included building a diverse and interdisciplinary research team structured to promote mentorship of junior researchers; utilizing local research assistants or technological tools such as telemedicine for language translation; making use of new tools such as mobile health (mHealth) to standardize and streamline data collection; identifying alternatives to local institutional review board (IRB) approval and the use of community consent when appropriate; and increased advocacy for global emergency care research funding. Conclusions Significant barriers to the conduct of high-quality global emergency care research persist, and innovative strategies need to be adopted in order to promote and grow the field of global emergency care research. This paper provides a global consensus on the most important barriers identified, as well as recommendations for cost-effective strategies for overcoming these barriers with the overall goal of promoting high-quality research and improving emergency care worldwide. This article is protected by copyright. All rights reserved.
  • References (20)
  • Citations (2)
Published on Nov 1, 2016in Emergency Medicine Journal2.31
Cindy Y. Chang4
Estimated H-index: 4
(Brigham and Women's Hospital),
Samer Abujaber4
Estimated H-index: 4
(Brigham and Women's Hospital)
+ 2 AuthorsZiad Obermeyer16
Estimated H-index: 16
(Harvard University)
Objective To estimate the global and national burden of emergency conditions, and compare them to emergency care usage rates. Methods We coded all 291 Global Burden of Disease 2010 conditions into three categories to estimate emergency burden: conditions that, if not addressed within hours to days of onset, commonly lead to serious disability or death; conditions with common acute decompensations that lead to serious disability or death; and non-emergencies. Emergency care usage rates were obtai...
Published on Aug 1, 2015in Tropical Medicine & International Health2.42
Smisha Agarwal7
Estimated H-index: 7
(Johns Hopkins University),
Henry Baker Perry19
Estimated H-index: 19
(Johns Hopkins University)
+ 1 AuthorsAlain B Labrique26
Estimated H-index: 26
(Johns Hopkins University)
Objectives Given the large-scale adoption and deployment of mobile phones by health services and frontline health workers (FHW), we aimed to review and synthesise the evidence on the feasibility and effectiveness of mobile-based services for healthcare delivery. Methods Five databases – MEDLINE, EMBASE, Global Health, Google Scholar and Scopus – were systematically searched for relevant peer-reviewed articles published between 2000 and 2013. Data were extracted and synthesised across three theme...
Published on Jan 1, 2014in Oncologist5.25
Bostjan Seruga1
Estimated H-index: 1
Aleksander Sadikov9
Estimated H-index: 9
+ 9 AuthorsNise Hitomi Yamaguchi1
Estimated H-index: 1
摘要 背景. 越来越多的癌症研究障碍引起了全球关注。本文探索了全球临床癌症研究的特征及其障碍。 方法. 美国临床肿瘤学会国际事务委员会从25个国家中遴选并邀请了300位具有研究经验的肿瘤科医生来完成一项网上调查。使用Fisher确切概率法来比较来自高收入国家(HIC)与低至中等收入国家(LMIC)参与者之间所提供的答案。临床癌症研究的各项障碍被分为1级(非常重要)到8级(最不重要)。通过Mann-Whitney非参数检验来比较纳入调查的障碍的重要性等级。 结果. 80位肿瘤科医生作出应答,其中41位来自HIC,39位来自LMIC。大多数应答者为就职于学术性医院(90%)的肿瘤内科医生(62%)。来自HIC的研究者在学术研究以及产业驱动的研究方面参与程度高于来自LMIC的研究者。有显著更高比例的HIC研究者认为,在过去的5年内开展学术研究以及产业驱动的研究 所面临的困难更大(与LMIC研究者相比,分别为73% vs. 27% 、70% vs. 30%)。就学术性临床癌症研究而言,缺乏资金被列为最重要(评分3.16)的障碍,HIC研究者与LMIC研究者之间未观察到显著差异。时间不够多或相互...
Published on Dec 1, 2013in Academic Emergency Medicine2.96
Alexander Vu10
Estimated H-index: 10
(Johns Hopkins University),
Herbert C. Duber12
Estimated H-index: 12
(UW: University of Washington)
+ 7 AuthorsStephen W. Hargarten26
Estimated H-index: 26
(MCW: Medical College of Wisconsin)
Over the past few decades there has been a steady growth in funding for global health, yet generally little is known about funding for global health research. As part of the 2013 Academic Emergency Medicine consensus conference, a session was convened to discuss emergency care research funding in the global health context. Overall, the authors found a lack of evidence available to determine funding priorities or quantify current funding for acute care research in global health. This article summ...
Published on Dec 1, 2013in Academic Emergency Medicine2.96
Jon Mark Hirshon21
Estimated H-index: 21
(UMB: University of Maryland, Baltimore),
Bhakti Hansoti7
Estimated H-index: 7
(Johns Hopkins University)
+ 4 AuthorsMichelle H. Biros29
Estimated H-index: 29
(UMN: University of Minnesota)
The 2013 Academic Emergency Medicine consensus conference focused on global health and emergency care research. One conference breakout session discussed research ethics and developed a research agenda concerning global acute care research ethics. This article represents the proceedings from that session, particularly focusing on ethical issues related to protecting human subjects while conducting acute care research. Protecting human research subjects from unnecessary risk is an important compo...
Published on Dec 1, 2013in Academic Emergency Medicine2.96
Michael S. Runyon15
Estimated H-index: 15
(Carolinas Medical Center),
Hendry R. Sawe7
Estimated H-index: 7
(MUHAS: Muhimbili University of Health and Allied Sciences)
+ 6 AuthorsKatherine Douglass4
Estimated H-index: 4
(GW: George Washington University)
As policy-makers increasingly recognize emergency care to be a global health priority, the need for high-quality clinical and translational research in this area continues to grow. As part of the proceedings of the 2013 Academic Emergency Medicine consensus conference, this article discusses the importance of: 1) including clinical and translational research in the initial emergency care development plan, 2) defining the burden of acute disease and the barriers to conducting research in resource...
Published on Dec 1, 2012in The Lancet59.10
Rafael Lozano-Ascencio61
Estimated H-index: 61
Mohsen Naghavi81
Estimated H-index: 81
+ 188 AuthorsStephanie Y Ahn8
Estimated H-index: 8
Summary Background Reliable and timely information on the leading causes of death in populations, and how these are changing, is a crucial input into health policy debates. In the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010), we aimed to estimate annual deaths for the world and 21 regions between 1980 and 2010 for 235 causes, with uncertainty intervals (UIs), separately by age and sex. Methods We attempted to identify all available data on causes of death for 187 c...
Published on Jul 1, 2012in Annals of Emergency Medicine5.21
Phillip D. Anderson15
Estimated H-index: 15
(Harvard University),
Robert E. Suter14
Estimated H-index: 14
(UTSW: University of Texas Southwestern Medical Center)
+ 3 AuthorsCharles Mock53
Estimated H-index: 53
(UW: University of Washington)
The recent adoption of World Health Assembly Resolution 60.22, titled "Health Systems: Emergency Care Systems," has established an important health care policy tool for improving emergency care access and availability globally. The resolution highlights the role that strengthened emergency care systems can play in reducing the increasing burden of disease from acute illness and injury in populations across the socioeconomic spectrum and calls on governments and the World Health Organization to t...
Published on Oct 5, 2010in PLOS Medicine
Maria W. Merritt11
Estimated H-index: 11
(Johns Hopkins University),
Alain B Labrique26
Estimated H-index: 26
(Johns Hopkins University)
+ 3 AuthorsJoan C. Pettit2
Estimated H-index: 2
(Johns Hopkins University)
The authors have declared that no competing interests exist. MWM's work on this manuscript was supported by a career development award from the Greenwall Faculty Scholars Program ( JK's work on this manuscript was partially supported by US National Institutes of Health grants ES015558 and HD061712. The funders had no role in the decision to submit the manuscript or in its preparation. Provenance: Not commissioned; externally peer reviewed.
Published on Jun 29, 2010in PLOS Neglected Tropical Diseases4.49
Trudie Lang26
Estimated H-index: 26
(University of Oxford),
Nicholas J White Frcp138
Estimated H-index: 138
(University of Oxford)
+ 10 AuthorsPhaik Yeong Cheah20
Estimated H-index: 20
Our aim is to raise awareness of the issues faced by researchers in developing countries and to introduce an initiative we are developing. We propose that the gaps and issues we have outlined could be largely addressed by building a community of researchers from all the various roles who will be able to access the information, guidance and resources they need, whilst also be able to share methods and pragmatic operational practices that have been locally derived and known to work. Some examples ...
Cited By2
Published on Jul 16, 2019in Academic Emergency Medicine2.96
Indi Trehan21
Estimated H-index: 21
(WashU: Washington University in St. Louis),
Maxwell Osei-Ampofo4
Estimated H-index: 4
(KNUST: Kwame Nkrumah University of Science and Technology)
+ 9 AuthorsDaniel K. Cho1
Estimated H-index: 1
(Brown University)
Published on Jul 10, 2019in Journal of Clinical Nursing1.76
Pauline Brown3
Estimated H-index: 3
Alistair Hewison10
Estimated H-index: 10
(University of Birmingham),
Roger Newham4
Estimated H-index: 4
(University of Birmingham)
Published on Nov 1, 2018in American Journal of Emergency Medicine1.65
Prashant Mahajan21
Estimated H-index: 21
(UM: University of Michigan),
Timothy Visclosky (UM: University of Michigan)+ 3 AuthorsRobert W. Neumar40
Estimated H-index: 40
(UM: University of Michigan)
Abstract Despite the fact that emergency care can impact health of populations, the global epidemiology of emergencies in children and adults is unknown and substantial variation exists in emergency infrastructure among different nations, especially among the low and middle income countries. Various research networks which are etiology specific or subspecialty specific, including emergency care based networks have positively impacted the health of populations. However, emergency departments (ED)...
Published on Oct 2, 2018in International Journal of Mental Health
Susan Caplan3
Estimated H-index: 3
(RU: Rutgers University),
Angelina Sosa Lovera1
Estimated H-index: 1
(Universidad Autónoma de Santo Domingo),
Patricia Reyna Liberato (Universidad Autónoma de Santo Domingo)