TY - JOUR
T1 - Identifying clinical research priorities in adult pulmonary and critical care
T2 - NHLBI working group report
AU - Semler, Matthew W.
AU - Bernard, Gordon R.
AU - Aaron, Shawn D.
AU - Angus, Derek C.
AU - Biros, Michelle H.
AU - Brower, Roy G.
AU - Calfee, Carolyn S.
AU - Colantuoni, Elizabeth A.
AU - Ferguson, Niall D.
AU - Gong, Michelle N.
AU - Hopkins, Ramona O.
AU - Hough, Catherine L.
AU - Iwashyna, Theodore J.
AU - Levy, Bruce D.
AU - Martin, Thomas R.
AU - Matthay, Michael A.
AU - Mizgerd, Joseph P.
AU - Moss, Marc
AU - Needham, Dale M.
AU - Self, Wesley H.
AU - Seymour, Christopher W.
AU - Stapleton, Renee D.
AU - Thompson, B. Taylor
AU - Wunderink, Richard G.
AU - Aggarwal, Neil R.
AU - Reineck, Lora A.
N1 - Publisher Copyright:
© 2020 by the American Thoracic Society.
PY - 2020/8/15
Y1 - 2020/8/15
N2 - Preventing, treating, and promoting recovery from critical illness due to pulmonary disease are foundational goals of the critical care community and the NHLBI. Decades of clinical research in acute respiratory distress syndrome, acute respiratory failure, pneumonia, and sepsis have yielded improvements in supportive care, which have translated into improved patient outcomes. Novel therapeutics have largely failed to translate from promising preclinical findings into improved patient outcomes in late-phase clinical trials. Recent advances in personalized medicine, "big data,"causal inference using observational data, novel clinical trial designs, preclinical disease modeling, and understanding of recovery fromacute illness promise to transformthemethods of pulmonary and critical care clinical research. To assess the current state of, research priorities for, and future directions in adult pulmonary and critical care research, the NHLBI assembled a multidisciplinary working group of investigators. This working group identified recommendations for future research, including 1) focusing on understanding the clinical, physiological, and biological underpinnings of heterogeneity in syndromes, diseases, and treatment response with the goal of developing targeted, personalized interventions; 2) optimizing preclinical models by incorporating comorbidities, cointerventions, and organ support; 3) developing and applying novel clinical trial designs; and 4) advancing mechanistic understanding of injury and recovery to develop and test interventions targeted at achieving long-term improvements in the lives of patients and families. Specific areas of research are highlighted as especially promising for making advances in pneumonia, acute hypoxemic respiratory failure, and acute respiratory distress syndrome.
AB - Preventing, treating, and promoting recovery from critical illness due to pulmonary disease are foundational goals of the critical care community and the NHLBI. Decades of clinical research in acute respiratory distress syndrome, acute respiratory failure, pneumonia, and sepsis have yielded improvements in supportive care, which have translated into improved patient outcomes. Novel therapeutics have largely failed to translate from promising preclinical findings into improved patient outcomes in late-phase clinical trials. Recent advances in personalized medicine, "big data,"causal inference using observational data, novel clinical trial designs, preclinical disease modeling, and understanding of recovery fromacute illness promise to transformthemethods of pulmonary and critical care clinical research. To assess the current state of, research priorities for, and future directions in adult pulmonary and critical care research, the NHLBI assembled a multidisciplinary working group of investigators. This working group identified recommendations for future research, including 1) focusing on understanding the clinical, physiological, and biological underpinnings of heterogeneity in syndromes, diseases, and treatment response with the goal of developing targeted, personalized interventions; 2) optimizing preclinical models by incorporating comorbidities, cointerventions, and organ support; 3) developing and applying novel clinical trial designs; and 4) advancing mechanistic understanding of injury and recovery to develop and test interventions targeted at achieving long-term improvements in the lives of patients and families. Specific areas of research are highlighted as especially promising for making advances in pneumonia, acute hypoxemic respiratory failure, and acute respiratory distress syndrome.
KW - Acute respiratory failure
KW - Clinical trials
KW - Mechanical ventilation
KW - Pneumonia
KW - Sepsis
UR - http://www.scopus.com/inward/record.url?scp=85098636463&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85098636463&partnerID=8YFLogxK
U2 - 10.1164/rccm.201908-1595WS
DO - 10.1164/rccm.201908-1595WS
M3 - Article
C2 - 32150460
AN - SCOPUS:85098636463
SN - 1073-449X
VL - 202
SP - 511
EP - 523
JO - American journal of respiratory and critical care medicine
JF - American journal of respiratory and critical care medicine
IS - 4
ER -