Emergency care research as a global health priority: key scientific opportunities and challenges

Junaid Razzak, Blythe Beecroft, Jeremy Brown, Stephen Hargarten, Nalini Anand, Junaid Razzak, Blythe Beecroft, Jeremy Brown, Stephen Hargarten, Nalini Anand

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.

Keywords: injury.

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Scope of emergency care.
Figure 2
Figure 2
Definition of emergency care.

References

    1. Thind A, Hsia R, Mabweijano J, et al. . Prehospital and Emergency Care : Debas HT, Donkor P, Gawande A, et al., Essential surgery: disease control priorities. 3rd edn Washington, DC: World Bank, 2015.
    1. Reynolds TA, Sawe H, Rubiano AM, et al. . Strengthening Health Systems to Provide Emergency Care : Jamison DT, Nugent R, Gelband H, et al., Disease control priorities: improving health and reducing poverty. 3rd edn Washington, DC: World Bank, 2017: 247–66.
    1. Razzak JA, Farooq U, Bhutta ZA. Measuring burden of emergency diseases using global burden of disease data. BMJ Glob Health. In Press.
    1. Chang CY, Abujaber S, Reynolds TA, et al. . Burden of emergency conditions and emergency care usage: new estimates from 40 countries. Emerg Med J 2016;33:794–800. 10.1136/emermed-2016-205709
    1. Bernstein SL, D’Onofrio G. Public health in the emergency department. Acad Emerg Med 2009;16:1037–9.
    1. Heymann DL, Chen L, Takemi K, et al. . Global health security: the wider lessons from the West African Ebola virus disease epidemic. Lancet 2015;385:1884–901. 10.1016/S0140-6736(15)60858-3
    1. Maitland K, Kiguli S, Opoka RO, et al. . Mortality after fluid bolus in African children with severe infection. N Engl J Med 2011;364:2483–95. 10.1056/NEJMoa1101549
    1. The United Nations The road to dignity by 2030: ending poverty, transforming all lives and protecting the planet, 2014. Available: [Accessed Oct 2018].
    1. Brown J. National Institutes of Health Support for Clinical Emergency Care Research, 2011 to 2014. Ann Emerg Med 2016;68:164–71. 10.1016/j.annemergmed.2016.01.039
    1. Brown J. National Institutes of health support for individual mentored career development grants in emergency medicine. Acad Emerg Med 2014;21:1269–73. 10.1111/acem.12517
    1. Jang DH, Levy PD, Shofer FS, et al. . A comparative analysis of National Institutes of health research support for emergency medicine – 2008 to 2017. Am J Emerg Med. In Press 2018. 10.1016/j.ajem.2018.12.045
    1. Fogarty International Center, Fogarty global injury and trauma research training program, 2017. Available: [Accessed Oct 2018].
    1. Reynolds TA, Bisanzo M, Dworkis D, et al. . Research priorities for data collection and management within global acute and emergency care systems. Acad Emerg Med 2013;20:1246–50. 10.1111/acem.12261
    1. Dickert NW, Brown J, Cairns CB, et al. . Confronting ethical and regulatory challenges of emergency care research with conscious patients. Ann Emerg Med 2016;67:538–45. 10.1016/j.annemergmed.2015.10.026
    1. Abujaber S, Chang CY, Reynolds TA, et al. . Developing metrics for emergency care research in low- and middle-income countries. Afr J Emerg Med 2016;6:116–24. 10.1016/j.afjem.2016.06.003
    1. Millum J, Beecroft B, Hardcastle TC, et al. . Emergency care research ethics in low-and middle-income countries. BMJ Glob Health. In Press.

Source: PubMed

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