Abstract
In the past five decades, trauma systems have emerged across North America and around the world as a comprehensive public health approach to a pervasive societal problem. Data from trauma centers worldwide have shaped clinical practice, systems design, and injury prevention. By viewing injury along a continuum of care, including injury prevention, and by accounting for the social determinants of health, the most successful trauma systems have made a substantial impact on trauma mortality. Now, with advances in genomics and proteomics, and with parallel explosions in digital technology and computing power, trauma systems will begin to navigate the era of precision medicine, which is already defining the frontiers of oncology, critical care, cardiology, and other disciplines. However, the precision medicine movement, which has focused on developing specific, and often expensive, therapies customized for individual patients, may be at odds with the societal approaches that have been taken in the development of trauma systems. Will investments in precision medicine divert support from and stall the momentum of public health and population-based approaches to health, as exemplified by trauma systems? This chapter explores the worldwide burden of traumatic injury, and the converging movements of trauma systems and precision medicine, including the ethical dimensions of choosing between societal and individual patient welfare, with violence-related injury as an example. By balancing ethics considerations and harnessing principles and capabilities of precision medicine, trauma surgeons and investigators have an opportunity to define and lead a new movement, precision injury control, at the intersection of trauma systems and precision medicine.
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References
American College of Surgeons. (2003). Code of professional conduct. https://www.facs.org/about-acs/statements/stonprin#code. Accessed 18 Jun 2018.
American College of Surgeons. (2018). Trauma quality improvement program (TQIP). https://www.facs.org/quality-programs/trauma/tqp/center-programs/tqip. Accessed 18 Jun 2018.
American Medical Association. (2016). AMA code of medical ethics. https://www.ama-assn.org/sites/ama-assn.org/files/corp/media-browser/principles-of-medical-ethics.pdf. Accessed 18 Jun 2018.
Bayer, R., & Galea, S. (2015). Public health in the precision-medicine era. The New England Journal of Medicine, 373, 499–501. https://doi.org/10.1056/NEJMp1506241
Branas, C. C., Mackenzie, E. J., Williams, J. C., Schwab, C. W., Teter, H. M., Flanigan, M. C., et al. (2005). Access to trauma centers in the United States. JAMA, 293(21), 2626. https://doi.org/10.1001/jama.293.21.2626
Brody, H. (2012). From an ethics of rationing to an ethics of waste avoidance. The New England Journal of Medicine, 366(21), 1949–1951. https://doi.org/10.1056/nejmp1203365
Canadian Medical Association. (2004). CMA code of ethics (Update 2004). https://www.med.mun.ca/getdoc/78d1ad8a-1cd7-440b-86ed-389e892bc6f2/CMA-Code-of-Ethics.aspx
Ciesla, D. J. (2007). Trauma systems and access to emergency medical care. The Journal of Trauma, 62(6), S51. https://doi.org/10.1097/ta.0b013e31806546eb
Cinnamon, J., Schuurman, N., & Crooks, V. A. (2008). A method to determine spatial access to specialized palliative care services using GIS. BMC Health Services Research, 8, 140. https://doi.org/10.1186/1472-6963-8-140
Collins, F. S., & Varmus, H. (2015). A new initiative on precision medicine. The New England Journal of Medicine, 372, 793–795. https://doi.org/10.1056/nejmp1500523
Ferkenhoff, E., & Little, D. (2018). The bleeding of Chicago. Citylab. https://www.citylab.com/equity/2018/02/the-bleeding-of-chicago/554141/. Accessed 18 Jun 2018.
Fuchs, V. R., & Milstein, A. (2011). The $640 billion question—Why does cost-effective care diffuse so slowly? The New England Journal of Medicine, 364, 1985–1987. https://doi.org/10.1056/nejmp1104675
Ghaferi, A. A., Myers, C. G., Sutcliffe, K. M., Pronovost PJ (2017). The next wave of hospital innovation to make patients safer. Harvard Business Review. https://hbr.org/2016/08/the-next-wave-of-hospital-innovation-to-make-patients-safer. Accessed 18 Jun 2018.
Gross, D. A. (2018). Chicago’s south side finally has an adult trauma center again. The New Yorker. https://www.newyorker.com/news/dispatch/chicagos-south-side-finally-has-an-adult-trauma-center-again. Accessed 18 Jun 2018.
Hashmi, Z. G., Zafar, S., Genuit, T., Haut ER, Efron DT, Havens J, et al. (2016). The potential for trauma quality improvement: One hundred thousand lives in five years. Academic Surgical Congress Abstracts Archive. http://www.asc-abstracts.org/abs2016/15-12-the-potential-for-trauma-quality-improvement-one-hundred-thousand-lives-in-five-years/. Accessed 18 Jun 2018.
Khoury, M. J., Iademarco, M. F., & Riley, W. T. (2016). Precision public health for the era of precision medicine. American Journal of Preventive Medicine, 50(3), 398–401. https://doi.org/10.1016/j.amepre.2015.08.031
Mock, C., Joshipura, M., Arreola-Risa, C., & Quansah, R. (2012). An estimate of the number of lives that could be saved through improvements in trauma care globally. World Journal of Surgery, 36(5), 959–963. https://doi.org/10.1007/s00268-012-1553-9
Moore, G. E. (1965). Cramming more components onto integrated circuits. Electronics, 86(8), 114–117. https://doi.org/10.1109/jproc.1998.658762
Nathens, A. B., Brunet, F. P., & Maier, R. V. (2004). Development of trauma systems and effect on outcomes after injury. Lancet, 363(9423), 1794–1801. https://doi.org/10.1016/s0140-6736(04)16307-1
National Academy of Sciences. (1966). Accidental death and disability: The neglected disease of modern society. Washington, DC: National Academies Press.
National Institutes of Health. (2018). All of us. https://allofus.nih.gov/. Accessed 18 Jun 2018.
Norton, R., & Kobusingye, O. (2013). Injuries. The New England Journal of Medicine, 368, 1723–1730. https://doi.org/10.1056/nejmra1109343
Office of the Press Secretary. (2015). FACT SHEET: President Obama’s precision medicine initiative. The White House President Barack Obama. https://obamawhitehouse.archives.gov/the-press-office/2015/01/30/fact-sheet-president-obama-s-precision-medicine-initiative. Accessed 18 Jun 2018.
Porter, M. E., & Lee, T. H. The strategy that will fix health care. Harvard Business Review; October 2013. https://hbr.org/2013/10/the-strategy-that-will-fix-health-care
Ramaswami, R., Bayer, R., & Galea, S. (2017). Precision medicine from a public health perspective. Annual Review of Public Health, 39, 153–168. https://doi.org/10.1146/annurev-publhealth-040617-014158
Richter, E. D. (2001). Death and injury from motor vehicle crashes: A public health failure, not an achievement. Injury Prevention, 7, 176–178. https://doi.org/10.1136/ip.7.3.176
Rotondo, M. F., Cribari, C., & Smith, R. S. (Eds.). (2014). Resources for optimal care of the injured patient. Chicago: American College of Surgeons, Committee on Trauma.
Rubin, R. (2015). Precision medicine: The future or simply politics? JAMA, 313(11), 1089–1091. https://doi.org/10.1001/jama.2015.0957
UMMC Admin. (2016). The history of the UM R Adams Cowley Shock Trauma Center. University of Maryland Medical System. https://www.umms.org/ummc/health-services/shock-trauma/about/history. Accessed 18 Jun 2018.
Utter, G. H., Maier, R. V., Rivara, F. P., Mock, C. N., Jurkovich, G. J., & Nathens, A. B. (2006). Inclusive trauma systems: Do they improve triage or outcomes of the severely injured? Journal of Trauma and Acute Care Surgery, 60(3), 529–535. https://doi.org/10.1097/01.ta.0000204022.36214.9e
Woolf, S. H., & Aron, L. Y. (2013). U.S. health in international perspective: Shorter lives, poorer health. Washington, DC: The National Academies Press.
Zargaran, E., Spence, R., Adolph, L., Nicol, A., Schuurman, N., Navsaria, P., et al. (2018). Association between real-time electronic injury surveillance applications and clinical documentation and data acquisition in a South African trauma center. JAMA Surgery, 153(5), e180087. https://doi.org/10.1001/jamasurg.2018.0087
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Hameed, S.M., Knebel, K., Rogers, S.O. (2020). The Future of Injury Control Is Precise. In: Siegler, M., Rogers Jr., S. (eds) Violence, Trauma, and Trauma Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-31246-6_14
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