Thank you for participating!

Thank you to all who contributed to the National Heart, Lung, and Blood Institute (NHLBI) Strategic Visioning Forum. Ultimately, over 1,000 ideas were submitted, with more than 42,000 votes. This remarkable response exceeded expectations and provided a wealth of ideas to draw upon as NHLBI moves forward. Please visit the NHLBI Strategic Visioning page to find out more about the NHLBI Strategic Visioning process.


Welcome to the National Heart, Lung, and Blood Institute (NHLBI) Strategic Visioning Forum. The Institute is gathering ideas for the most compelling scientific priorities in the four NHLBI Strategic Goals to address over the next decade.

Strategic Goal: Goal 3: Advance Translational Research

Research Opportunities in HLB to Facilitate Aging in Place

There is a need for greater evidence-based research over the next 5-10 years to reduce healthcare costs, reduce hospitalizations, and support older persons with significant heart, lung, blood, sleep conditions to remain in their private homes if feasible, if technology is utilized that fosters clinical and epidemiologic research.

Submitted by (@nhlbiforumadministrator1)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Details on the impact of addressing this CQ or CC :

No other force will have as big of an impact on our health system as the unalterable rate of our aging population and subsequent increased rate of heart, lung and blood diseases. The impact of doing nothing is unforeseeable.

Feasibility and challenges of addressing this CQ or CC :

Evidence-based research over the next 5-10 years to reduce healthcare costs, reduce hospitalizations, and support older persons with significant heart, lung and blood conditions remain in their private homes is feasible if technology is utilized that fosters clinical and epidemiologic research.

Many cardiovascular risk factors increase as the population ages including uncontrolled systolic hypertension and atherosclerosis both contributing to the well-being of our society and increasingly high health care costs (Izzo, Levy, & Black, 2012). No other force will have as big of an impact on our health system as the unalterable rate of our aging population and subsequent increased rate of heart, lung and blood diseases. The impact of doing nothing is unforeseeable.

Name of idea submitter and other team members who worked on this idea : NHLBI Staff

Voting

17 net votes
35 up votes
18 down votes
Active

Strategic Goal: Goal 3: Advance Translational Research

Create a National Action Plan for COPD

Lead a coordinated effort of government, patient advocacy organizations, professional organizations, payers and others to plan and implement a coordinated plan to improve COPD awareness, education for patients and healthcare professionals, treatment strategies, research and data collection, policies and public health infrastructure and programs.

Submitted by (@jsullivan)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Details on the impact of addressing this CQ or CC :

Unlike most leading causes of death and disability, there is no coordinated effort to lower disease burden associated with COPD. Coordinated plans provide a forum for identifying the most pressing issues that must be tackled, for setting goals and convening partners from different disciplines and are a framework upon which policy change can be achieved. In order to make meaningful progress in the impact that COPD is having on patients, health systems and payers, coordinated planning and action is needed and NHLBI can lead the way but time is of the essence.

Feasibility and challenges of addressing this CQ or CC :

There are proven models of multi-stakeholder, public and private partnerships to tackle disease burden and create national plans. There are also multiple national and regional organizations standing ready to assist in these efforts.

Name of idea submitter and other team members who worked on this idea : COPD Foundation Board of Directors, COPDF MASAC, COPDF State Advocacy Captains

Voting

6 net votes
6 up votes
0 down votes
Active

Strategic Goal: Goal 2: Reduce Human Disease

Impact of Hydroxyurea on Organ Function

Does hydroxyurea preserve organ function in patients with sickle cell disease?

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

Hydroxyurea is the only disease-modifying medication for sickle cell disease, and has been shown to be effective in reducing complications such as pain crisis and acute chest syndrome in some patients. Evidence suggests that hydroxyurea is underused, and, understandably, efforts are underway to encourage more people to take advantage of this treatment. Determining that it preserves organ function or reduces organ damage could encourage greater use or, if not, encourage the development of other medications that can.

Feasibility and challenges of addressing this CQ or CC :

Given the greater understanding of sickle cell disease and improvements in life expectancy, it should be feasible to design a study that will supply sufficient data to answer this question.

Name of idea submitter and other team members who worked on this idea : The Sickle Cell Association of New Jersey

Voting

7 net votes
7 up votes
0 down votes
Active

Strategic Goal: Goal 2: Reduce Human Disease

The Importance of the Microbiome in Recovery after Hematopoietic Stem Cell Transplantation

Do modifications in the recipient gut or lung microbiome affect development of tolerance and immunologic recovery after allogeneic hematopoietic stem cell transplantation (HCT) and can re-institution of a more normal microbiome lead to improved outcomes?

Submitted by (@marymh)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Details on the impact of addressing this CQ or CC :

HCT leads to profound changes in the host microbiome. Some small studies indicate that differential recovery of the gut microbiome is associated with differential outcomes, including graft-versus-host disease and mortality. Less is known about the pulmonary microbiome. Better understanding of the role of the microbiome in facilitating posttransplant recovery could lead to easily administered interventions and provide important insights into the role of different subpopulations of the microbiome on the health of all people.

Feasibility and challenges of addressing this CQ or CC :

Preclinical and clinical studies of this area would be greatly facilitated by a microbiome repository linked to high quality clinical data and would provide opportunity for insight into the role of the microbiome in health and disease.

Name of idea submitter and other team members who worked on this idea : Mary Horowitz

Voting

117 net votes
152 up votes
35 down votes
Active

Strategic Goal: Goal 1: Promote Human Health

Combinatorial intervention of immune dynamics to combat cariovascular disease

Human health and disease are modulated by complex and inter-connected dynamic processes. With particular significance, a well-balanced immune environment may play a key role in maintaining health and preventing the pathogenesis of cardiovascular disease. Defining the dynamic programming and balance of immune environment will be the key for combinatorial therapies to reset homeostasis.

Submitted by (@lwli00)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Name of idea submitter and other team members who worked on this idea : Liwu Li

Voting

8 net votes
10 up votes
2 down votes
Active

Strategic Goal: Goal 2: Reduce Human Disease

How gene mutations contribute to defects in vascular development

How do gene mutations in endoglin and alk 1 create arteriovenous malformations leading to disease. Alk 1 and endoglin are receptors in TGFB/BMP family signaling. TGFB/BMP have roles in vascular development, remodeling and maintenance in vascular integrity. Understanding the downstream effect will lead to advancements in reducing genetic diseases such as HHT as well as vascular malformations in general

Submitted by (@mariannes.clancy)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Name of idea submitter and other team members who worked on this idea : Marianne Clancy MPA, Chris Hughes PhD

Voting

3 net votes
3 up votes
0 down votes
Active

Strategic Goal: Goal 1: Promote Human Health

Engineering Healthy Lungs

What tools and knowledge are required to engineer healthy lungs? Can we engineer lungs and/or successfully modify cadaveric donor lungs using our understanding of matrix biology and lung development to provide a durable effective organ replacement therapy for patients with advanced lung disease?

Submitted by (@nhlbiforumadministrator1)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Name of idea submitter and other team members who worked on this idea : NHLBI Staff

Voting

2 net votes
8 up votes
6 down votes
Active

Strategic Goal: Goal 3: Advance Translational Research

COPD risk categories and resource utilization

Can a tool be developed to group patients into risk categories for resource utilization?

Submitted by (@jimandmarynelson)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

COPD is usually blamed on smoking - first-hand smoke, second-hand smoke, and third-hand smoke. In reality, smoking is a major contributing factor. However, many other factors may lead to destruction of the breathing mechanisms in human lungs. Premature birth, exposure to industrial or agricultural chemicals, breathing dirty air, and a genetic factor known as Alpha-1 Antitrypsin Deficiency, as well as other factors may lead to COPD. In addition, COPD encompasses emphysema, chronic bronchitis, and certain types of incurable asthma, normally a combination of two or more of these disorders.

Each category of COPD requires its individual research approach.

Name of idea submitter and other team members who worked on this idea : Mary E. Nelson, caregiver, Arizona State Advocacy Captain, Copd Foundation

Voting

19 net votes
21 up votes
2 down votes
Active

Strategic Goal: Goal 1: Promote Human Health

Bypass the CSR and concurrently act to help reform it

A key aspect of making any strategic plan focused upon glycoscience funding effective is the mechanisms by which grants are chosen. The problem is not the IC and making prioritized decisions; the problem is the study section ignorance and bias. Proposals that are reviewed poorly in study section out of flippancy towards glycobiology or simple lack of a critical mass of appropriate expertise never see the light of day ...more »

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Feasibility and challenges of addressing this CQ or CC :

In order to truly promote glycobiology at the NHLBI, I would suggest two action items: 1) Heavily rely upon the RFA mechanisms in which the scientific review process is internal to the NHLBI or

special emphasis panel to ensure proper representation of glycobiologists on the panel. The success of this approach can be seen in the NHLBI-funded Programs of Excellence in Glycoscience (PEG), and I would predict similar success with the nascent NIH Common Fund Initiative in Glycosciences.

2) As much as possible, place significant pressure on the CSR to integrate far more glycobiology expertise into all standing study sections. As far as I can tell, any pressure placed on the CSR from the research community has fell upon deaf ears. One glycobiologist on a panel is inadequate.

Name of idea submitter and other team members who worked on this idea : Brian Cobb

Voting

1 net vote
1 up votes
0 down votes
Active

Strategic Goal: Goal 4: Develop Workforce and Resources

Training Support for Non-Research-Intensive Institutions

Institutions that are less research intensive, which may characterize some of the Historically Black Colleges and Universities, Hispanic Serving Institutions and tribal institutions with primarily minority faculty and/or student body, may need additional support for training researchers and for performing both hypothesis driven and student integrated research to provide an environment conducive with NIH efforts to enhance ...more »

Submitted by (@treva0)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Details on the impact of addressing this CQ or CC :

The grant submission process involves increasingly sophisticated administrative mechanics that many of these institutions do not have the resources to systematically or efficiently support with the requisite grant submissions and administration staff. For example, many challenges exist in putting together complex budgets with subcontracts, completing some (all) of the forms for on-line submission with increasing numbers of new RFA specific required documents, and recognizing the amount of time required to complete the submission process given the increasing number of previously not required mandates. In non-research-intensive institutions, there may be limited or no administrative support for these purely mechanical procedures, and additional training and resources are needed to support the increasingly complex grant process.

Name of idea submitter and other team members who worked on this idea : Treva Rice for the PRIDE (Programs to increase diversity among individuals engaged in health-related research): Joe GN “Skip” Garcia, Francisco Moreno Girardin Jean-Louis, Gbenga Ogedegbe, DC Rao, Victor Davila-Roman, Mohamed Boutjdir, Betty Pace, Juan Gonzales, Bettina M Beech, Keith Norris, Marino Bruce, Alicia Fernandez, Kirsten Bibbins-Domingo, and Margaret Handley.

Voting

-1 net votes
6 up votes
7 down votes
Active

Strategic Goal: Goal 1: Promote Human Health

Would unconditional basic income improve people's health & ease poverty better than conventional welfare programs?

Here's an article on the "Mincome" program which Canada tested in the 1970's in a small town: http://www.dominionpaper.ca/articles/4100 It had many positive effects on people's lives and health. Quotes: 'In the period that Mincome was administered, hospital visits dropped 8.5 per cent.' [...] '“When you walk around a hospital, it's pretty clear that a lot of the time what we're treating are the consequences of poverty,” ...more »

Submitted by (@apollia112)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

See comments

Feasibility and challenges of addressing this CQ or CC :

See comments

Name of idea submitter and other team members who worked on this idea : Apollia

Voting

0 net votes
2 up votes
2 down votes
Active

Strategic Goal: Goal 4: Develop Workforce and Resources

Promoting collaborations to advance research

Insufficient funding and resources hamper scientific progress. Providing funding opportunities that require collaborations across multiple institutions would encourage open and collaborative research while promoting advances in research due to complementary expertise, sharing of resources, combining scientific efforts, etc.

Submitted by (@feghalib)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Details on the impact of addressing this CQ or CC :

It would enhance research, accelerate the pace of discoveries, create collegial and collaborative environments across institutions and research groups. It would also promote team science and foster junior investigators who will learn the advantages of collaborating and functioning as a team.

Feasibility and challenges of addressing this CQ or CC :

It would require funding opportunities with availability of funds being contingent on collaborations across a certain number of institutions/centers having complementary resources, expertise, & research teams.

Name of idea submitter and other team members who worked on this idea : CFB

Voting

36 net votes
44 up votes
8 down votes
Active