March 19, 2018

Castro Leads Bipartisan Push for National Trauma Research Action Plan

Washington, D.C.—Congressman Joaquin Castro (TX-20), a member of the House Foreign Affairs Committee and the House Permanent Select Committee on Intelligence, led a bipartisan request to the House Appropriations Subcommittee on Defense Chairwoman Kay Granger and House Appropriations Subcommittee on Defense Ranking Member Peter J. Visclosky to include $9.2 million in the Defense Health Program Research and Development account for the National Trauma Research Action Plan. The letter was led by Reps. Joaquin Castro, Will Hurd; C.A. Dutch Ruppersberger; and Joseph P. Kennedy III.

“The principal elements of the NTRAP effort would be: performing a gap analysis of military and civilian trauma research to identify priorities across the continuum of care; defining optimal metrics to assess long-term outcomes in injured patients; cataloging current federal funding for trauma research, as currently there is no such resource; and identifying regulatory barriers to conducting trauma research, recommending best practices as well as appropriate funding levels to address critical gaps,” the Members wrote.

The Members continued: “Experts across the continuum of care would be recruited to lead in such areas as pre-hospital trauma care, mass casualty response, acute resuscitation, critical care, neurotrauma, orthopedic trauma, burns, geriatric trauma, pediatric trauma, injury prevention and rehabilitation. A steering committee with leaders from each of these areas would direct the project.”

The letter was also signed by Rep. Lamar Smith (TX-21); Rep. Yvette D. Clarke (NY-09); Rep. Rick Larsen (WA-02); Rep. Seth Moulton (MA-06); Rep. Donald M. Payne, Jr. (NJ-10); Rep. Filemon Vela (TX-34); Rep. Dina Titus (NV-01); Rep. Barbara Lee (CA-13); Rep. Tim Walz (MN-01); Rep. John Katko (NY-24); Whip Steny Hoyer (MD-05); Ranking Member Elijah Cummings (MD-07); Rep. Anthony G. Brown (MD-04); Rep. John K. Delaney (MD-06); Rep. Collin Peterson (MN-07); Rep. Rosa DeLauro (CT-03); Rep. Jamie Raskin (MD-08); Ranking Member John Yarmuth (KY-03); Rep. Ed Perlmutter (CO-07); Rep. Stephen F. Lynch (MA-08); Rep. John Sarbanes (MD-03); Rep. Elizabeth H. Esty (CT-05); Rep. Alan Lowenthal (CA-47); Rep. Lloyd Doggett (TX-35); Rep. Sheila Jackson Lee (TX-18); Rep. André Carson (IN-07); Rep. Steve Cohen (TN-09); Rep. Eleanor Holmes Norton (DC); Rep. Raúl Grijalva (AZ-03); Rep. Niki Tsongas (MA-03); Rep. Walter B. Jones (NC-03); Rep. Bobby L. Rush (IL-01); Rep. Danny K. Davis (IL-07); Rep. Richard M. Nolan (MN-08); Rep. Joyce Beatty (OH-03); Rep. Peter Defazio (OR-04); Rep. Henry C. “Hank” Johnson, Jr. (OH-06); Rep. Doris Matsui (CA-06); Rep. Sean Patrick Maloney (NY-18); Rep. Daniel Lipinski (IL-03); Rep. Anna G. Eshoo (CA-18); Rep. Albio Sires (NJ-08); Rep. Andy Harris, M.D. (MD-01); Rep. John Garamendi (CA-03); Rep. Emanuel Cleaver, II (MO-05); Rep. Ted Lieu (CA-33); Rep. Denny Heck (WA-10); Rep. James P. McGovern (MA-02); Rep. Diana Degette (CO-01) ; Rep. Beto O’Rourke (TX-16); Rep. Raja Krishnamoorthi (IL-08); Rep. Susan Davis (CA-53); Rep. Tulsi Gabard (HI-02); Rep. Rodney Davis (IL-13); and Rep. William R. Keating (MA-09).

Full text of the letter can be found here and follows.

March 16, 2018

Honorable Kay Granger, Chairwoman                                  

Subcommittee on Defense                                         

U.S. House Committee on Appropriations               

H-405, The Capitol                                                    

Washington, D.C. 20515                                                       

 

Honorable Peter J. Visclosky, Ranking Member

Subcommittee on Defense                                                                 

U.S. House Committee on Appropriations

1016 Longworth House Office Building

Washington, D.C. 20515                                                       


Dear Chairwoman Granger and Ranking Member Visclosky:

As you consider the defense medical research program for FY2019, we respectfully request that you include $9.2 million in the Defense Health Program R&D account for the “National Trauma Research Action Plan,” or NTRAP. The National Academies of Sciences, Engineering, and Medicine (NASEM) recommended the creation of the NTRAP in a seminal evaluation of trauma care and research in 2016. Study authors viewed the NTRAP as a critical element in a comprehensive plan to achieve a goal of zero preventable trauma deaths – defined as a life that could have been saved by appropriate and timely medical care -- in both our military and civilian sectors. Studies have estimated that 25% of battlefield deaths and 20% of civilian deaths after injury are survivable.

Whether sustained in military service or civilian life, traumatic injury is a major public health problem. Since 2001, trauma has caused nearly 7,000 combat-related deaths. Additionally, nearly 200,000 U.S. civilians suffer a fatal injury each year; and for every death due to injury, another 3 to 4 people survive with life-limiting disabilities or pain. Injury is the leading cause of death in individuals up to the age of 46, including children.

Study authors conceived the NTRAP as a means to “strengthen trauma research and ensure that the resources available for this research are commensurate with the importance of injury and the potential for improvement in patient outcomes.” Yet one study of NIH funding showed that trauma ranks last in funding compared to its burden among 27 disease categories. The NASEM report concluded that a unified effort across federal agencies is required and that the NTRAP is the mechanism to unify and focus research agendas on the most critical problems.

The principal elements of the NTRAP effort would be:  performing a gap analysis of military and civilian trauma research to identify priorities across the continuum of care; defining optimal metrics to assess long-term outcomes in injured patients; cataloging current federal funding for trauma research, as currently there is no such resource; and identifying regulatory barriers to conducting trauma research, recommending best practices as well as appropriate funding levels to address critical gaps. Experts across the continuum of care would be recruited to lead in such areas as pre-hospital trauma care, mass casualty response, acute resuscitation, critical care, neurotrauma, orthopedic trauma, burns, geriatric trauma, pediatric trauma, injury prevention and rehabilitation. A steering committee with leaders from each of these areas would direct the project.

Chairwoman Granger and Ranking Member Visclosky, our military has long had the lead among federal agencies in trauma. It is time for Congress to put these sound recommendations into practice, and we believe this request will fully fund such a NASEM-recommended plan for future trauma research, leading to the stated goal of zero preventable trauma deaths.

Thank you for your consideration of our request.

Sincerely,

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