This document, commissioned by the National Highway Traffic Safety Administration and the Maternal and Child Health Bureau, describes the history and current status of EMS research. Within its pages, impediments to the growth of scientific investigation in the field are identified; and strategies are suggested for improving the quality and quantity of EMS research with the goal of providing a scientific foundation upon which to base current and future prehospital care. We describe a culture of EMS that has been slow to respond to, recognize, and utilize the potential that exists in technology and science today. The time for major advancement in the science and practice of EMS is here. Emergency Medical Service providers must be able to deliver state of the art care based on sound scientific knowledge. A number of us, our families, or our friends will at some point turn to local EMS providers for assistance; and we expect that they will provide us with the best care possible.
Process
The EMS Agenda for the Future1 focused attention on the need for advancing quality research in the area of Emergency Medical Services. The EMS Agenda for the Future Implementation Guide2 specifically identified the creation of a national EMS research agenda as one of the top ten priorities necessary for this need to be realized. The National EMS Research Agenda is the result of a multidisciplinary process involving expert panel discussions, revision and review by a national writing team, and peer review of the resultant materials. The process of writing the Research Agenda was modified from the National Institutes of Health Technology Assessment and Practice Guidelines Forum.3 A cooperative agreement with the National Highway Traffic Safety Administration (NHTSA) and the Maternal and Child Health Bureau (MCHB) of the Health Resources Services Administration was established with the National Association of EMS Physicians in July 1999. A writing team, consisting of ten individuals from varying backgrounds, developed and reviewed the initial drafts of the document (Appendix A). A national review team, comprised of 36 individuals representing a wide variety of EMS related organizations (Appendix B), reviewed the preliminary document and provided valuable feedback and suggestions for improvement. The completed, revised draft was widely distributed to EMS-interested organizations and individuals for peer review. The draft was also posted on the World Wide Web at www.ResearchAgenda.org. Over four hundred individuals independently reviewed this document.. The National EMS Research Agenda includes input from all who participated in this process, but the primary authors are responsible for its content and any errors or omissions therein.
Similar Efforts
Similar efforts to appraise research needs in medicine and within EMS have been conducted by other organizations. The Association of American Medical Colleges offers their view of the broad field of clinical research in a document entitled Breaking the Scientific Bottleneck, available on their web site at www.aamc.org/newsroom/clinres. One major observation in this document was that, “Clinical research is not adequately understood or valued by the public.” A comprehensive overview of the EMS system for children was published by The Institute of Medicine in 1993. This publication includes a list of research priorities.4 The EMS Outcomes Project compiled a prioritized list of conditions for adults and children that were amenable to EMS study, and included a list of EMS research topics.5 The Emergency Medical Services for Children program supported a similar project in which a list of important topics for future research in emergency medical services for children was developed for use by foundations, governmental agencies, and others in setting research agenda for such services.6
We add this document to the growing body of work calling attention to the need for the timely advancement of quality EMS research. It is our intent that this document be used by policy makers, EMS professionals and administrators, academicians, and interested members of the public as rationale for the allocation of resources to EMS research. We envision a not-too-distant future in which funding is available to enable collaboration between EMS professionals and academicians, support multi-center research, facilitate the development of new researchers, support the effective use of data from national databases, integrate education and training regarding research into EMS practice, and to promote the evaluation of important treatments in an efficient and highly productive manner.
It is time for change, time to make a difference, and time to limit injury and suffering within our capacity to do so. This document is intended to provide direction for the steps that must be taken to improve prehospital care for all Americans.
