DoD Precision Trauma Care Research Award

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In support of the Precision Medicine Initiative1, the OASD(HA) identified “precision medicine” as a top science and technical priority for the FY17 DHP RDT&E funds (this is also applicable to FY18 DHP RDT&E funds) and directed DHA to increase the use of “big data” and interdisciplinary approaches, establish a fundamental understanding of military disease and injury, and advance health status assessment, diagnosis, and treatment tailored to individual Service members and beneficiaries. For this Program Announcement/Funding Opportunity, precision medicine is defined as “an emerging approach for disease treatment and prevention that takes into account individual variability in genes, environment, and lifestyle for each person.”2 Precision medicine pioneers a new model of patient-powered research that aims to accelerate biomedical discoveries and provide clinicians with new tools, knowledge, and approaches to select more accurate treatment and prevention strategies that will work best for individual patients. The intent of the Precision Trauma Care Research Award (PTCRA) is to support research applying precision medicine concepts to trauma care. In order to improve the care of combat casualties, the JPC-6/CCCRP requires capabilities to more accurately diagnose and treat injuries. In general, the field of trauma care progresses as empirical evidence accumulates. Accumulated evidence supports the reduction of unwarranted practice variability (e.g., protocol-driven care). Reduction in practice variability leads to refinement of protocols through improved diagnostic and prognostic indicators that account for patient-specific variables such as injury pattern, co-morbidities, demographics, and morphometric data. These approaches are further refined by incorporation of near-term patient-specific variables such as injury progression, response to interventions, and theranostic indicators. The result is a precision medicine approach for trauma care that drives application of interventions to improve outcomes following trauma. The JPC-6/CCCRP seeks to develop precision medicine approaches for trauma care in the most challenging of environments, including point-of-injury care on the battlefield, deployed healthcare facilities such as casualty collection points, forward surgical teams, and combat support hospitals. This challenge of diverse combat environments and medical capabilities also requires research to develop new solutions to include support for medical providers in the assessment, diagnosis, and treatment of military trauma in out-of-hospital settings (point of injury, austere environment, or en route care) with limited resources through Role 4.3 Proposed research should consider the entire continuum of trauma care and must be focused on enabling patient-specific interventions and improved outcomes rather than “one size fits all” population-based tools and techniques.

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