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.

Goal 4: Develop Workforce and Resources

Preparing for Transdisciplinary Research

There is a need to develop training programs, mentorship, and collaborations that cross boundaries and prepare researchers for future transdisciplinary needs.

Submitted by (@nhlbiforumadministrator)

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 : NHLBI Staff

Voting

10 net votes
18 up votes
8 down votes
Active

Goal 2: Reduce Human Disease

Transplant to Cure Older Adults with Hematologic Malignancy-Removing the Blindfold

While transplant for patients 60 and older for high-risk hematologic malignancies has increased and observational data are promising, the risks and benefits of translant versus non-transplant remain largely unknown. We now have the tools and mechanisms to remove the blindfold! The NHLBI should support the cooperative groups in conjunction with the BMT-CTN to establish a common framework for transplant trials in older ...more »

Submitted by (@aartz0)

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

Details on the impact of addressing this CQ or CC :

Hematologic malignancies are more common and less treatable in older patients. This trend will contine as the number and proportion of older people in society increases. Older patients are frequently treated but rarely on studies. The availability of haploidentical and cord donor sources, better supportive care, and more tolerable regimens permits transplant to be widely accessible and utilized.

 

A critical question for the entire field of hematologic malignancies is determing the risks and benefits of allogeneic transplant for older adults. This question is posed across the country, every day by every patient and physician struggling to treat older adults with hematologic malignancies. The confluence of molecular and cytogenetic disease markers and novel measures of patient health should permit identifying those most likely to be cured and those least likely to benefit. Such data will ultimately inform the next generation of transplant trials in this population.

Feasibility and challenges of addressing this CQ or CC :

The number of patients with any of these diseases (e.g., AML, MDS, NHL and perhaps ALL) who are 60 years and older is significant. The challenge is to develop a coordinated effort to prospectively capture disease and patient health data to answer which subgroups benefit or do not.

Methods to capture patient health status have already been developed through a standardized Geriatric Assessment used in the Alliance and other studies. Most of the survey can be done electronically by a patient or by telephone. Disease based molecular markers have emerged as standard measures within cooperative group studies to augment cytogenetic and morphologic classification.

 

Ensuring cooperative groups develop uniform design and data may be difficult. Yet investigators gain much and lose little by standardizing the data capture of what already occurs (patients moving to transplant on hematologic malignancy trials).

 

Another challenge is to develop standardized measures after transplant beyond survival such as function free survival and quality of life that are patient centered. Electronic tools to capture data, especially for non-transplant patients, will greatly reduce this burden.

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

Voting

20 net votes
36 up votes
16 down votes
Active

Goal 1: Promote Human Health

Enhancing Understanding of Determinants of Health in Rural Areas & Developing Solutions

What are the biological, environmental, social and economic determinants of health in rural areas related to COPD and other lung disease.

Submitted by (@gacdk0)

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

Details on the impact of addressing this CQ or CC :

There are extreme disparities in the impact of COPD in rural areas, especially in rural Appalachia. These areas experience much larger prevalence rates and higher rates of hospitalization, readmissions and other health indicators that contribute to increased cost and decreased quality of life. These are also areas with the least ability to make improvements. Research that can inform both the causes of these disparities and identify proven methods for systematically confronting these issues has the potential to dramatically improve overall health status in rural America

Name of idea submitter and other team members who worked on this idea : Grace Anne Dorney Koppel

Voting

7 net votes
8 up votes
1 down votes
Active

Goal 2: Reduce Human Disease

Pulseless Electrical Activity (PEA) - replacing VF/VT

As VF/VT rates continue to decrease in cardiac arrest to levels below 25%, the importance of understanding the pathways and epidemiology of PEA gains public health importance. Additionally, there is a need to determine the co-morbidities and/or pharmacologic agents that contribute to the causation of this rhythm.

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 :

Greater understanding of PEA would lead to better treatment (good CPR only treatment currently) and higher survival rate in CA

Feasibility and challenges of addressing this CQ or CC :

How will be treat the majority of cardiac arrest when it becomes PEA?

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

Voting

-9 net votes
7 up votes
16 down votes
Active

Goal 1: Promote Human Health

Lung disease hits/triggers

What are the hits/triggers that occur early in life that predispose to lung disease later in life?

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 :

While we are fully supportive of the recent emphasis on patient‐centered outcomes and implementation science, we are also reminded of the critical importance of investigating underlying mechanisms of pulmonary, critical care and sleep disorders. Recent discoveries have created exciting progress in the areas of cystic fibrosis, pulmonary hypertension, pulmonary fibrosis, and biological therapies in asthma. Only through further efforts to elucidate underlying mechanisms are new therapeutic approaches likely to emerge. Promoting further academic‐industry interactions are likely to yield benefits, which will ultimately lead to improvements in the health of our nation.

Name of idea submitter and other team members who worked on this idea : Research Advocacy Committee, American Thoracic Society

Voting

0 net votes
1 up votes
1 down votes
Active

Goal 2: Reduce Human Disease

Clinical Trials & Duplicative Regulatory Standards

The initiation of clinical trials remains difficult, time-consuming, and costly. Repetitive institutional review board oversight is one of several obstacles to efficient clinical trial initiation and completion. New strategies for addressing duplicative regulatory standards are necessary to ease the initiation and completion of trials.

Submitted by (@skrenrich)

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 : Cystic Fibrosis Foundation

Voting

5 net votes
6 up votes
1 down votes
Active

Goal 1: Promote Human Health

Improving cardiovascular health

The scientific and clinical ramifications of the transulfurization systems are just beginning to be explored. Research methods and hypotheses should be explored.

Submitted by (@dnelson)

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

Details on the impact of addressing this CQ or CC :

The transulfuration pathway and H2S play key roles in cellular metabolism and are adversely affected by inflammation and the oxidative stress of chronic disease. Enhancing our knowledge of these systems and the various players would significantly benefit prevention and treatment.

Feasibility and challenges of addressing this CQ or CC :

This is a HOT area and breakthroughs are being announced daily.

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

Voting

-1 net votes
7 up votes
8 down votes
Active

Goal 1: Promote Human Health

Establishment of a permanent exercise study section

Funding opportunities explicitly for studies of exercise have not been a major NIH priority. The NHLBI has been an exception to this, but the non-existence of a true exercise study section still makes funding a challenge for individuals in the field of Exercise Science. Exercise, along with sleep and diet, is one of the pillars of health and has been shown to be highly beneficial for a number of medical conditions. However, ...more »

Submitted by (@mschubert2)

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 : MattS

Voting

202 net votes
290 up votes
88 down votes
Active

Goal 2: Reduce Human Disease

National cardiac arrest registry

Cardiac arrest registries are needed to measure and improve the process and outcome of resuscitation care and provide a platform for exploring insight into risk factors, prognosis, and the effectiveness of interventions for out-of-hospital (OHCA) and in-hospital cardiac arrest (IHCA).

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 :

develop registry provide contemporary data of local, regional and nation wide EMS practices in managing OHCA to address and develop successful resuscitation strategies across gender, age and race categories.

Feasibility and challenges of addressing this CQ or CC :

combining ROC (Resuscitation Outcomes Consortium) and CARES (Cardiac Arrest Registry to Enhance Survival), the two largest North American existing OHCA registries have different (regional) foot print, quality control measures and thus goals. CARES was developed as U.S. based surveillance registry across majority of states and not a research database; therefore, collected only the minimum number of data elements that are known to be essential in the response and treatment of OHCA. ROC is a North American registry conducted at 10 major regions with a detailed and high quality CPR process data providing not only the OHCA rates but also detailed CPR characteristics. Combining a large geographic foot print with sites with established quality controls would offer insight into rural, suburban and urban OHCA resuscitation dynamics on which resuscitation strategies would be based.

It is well recognized that there are marked variations in survival from OHCA and IHCA among centers as well temporal trends, however, factors associated with it are incompletely understood. Ongoing quality data are needed to advance our understanding of resuscitation care, as well as variations in EMS/ED practices.

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

Voting

-8 net votes
9 up votes
17 down votes
Active

Goal 3: Advance Translational Research

Public-Private Partnerships to Improve Nutrition & Reduce Obesity

How can we best encourage and support collaborations between academic researchers and industry partners to test strategies for changing nutritional choices and eating behaviors to healthier patterns that can improve obesity rates? Subquestions include issues around adopting healthier food choices in a variety of environments, effects of diet alteration, the methods and effects of enhancing healthier food flavors, understanding ...more »

Submitted by (@nhlbiforumadministrator1)

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

Details on the impact of addressing this CQ or CC :

The food industry is a powerful force in determining the eating patterns of the US population. Given its influence, collaborative efforts between academia and industry to promote healthier eating patterns could have an enormous impact on obesity rates and cardiovascular health over the long-term.

Feasibility and challenges of addressing this CQ or CC :

Efforts to forge public-private partnerships in nutrition and obesity research are in formative stages and expected to grow substantially over the next decade, It is timely to take advantage of industry interest in such partnerships to answer questions of interest to academic researchers that can benefit from the resources and expertise brought to bear by industry.

Using public-private partnership models, academic researchers could be encouraged to partner with industry on topics of mutual interest; industry partners could ideally provide “in-kind” resources (e.g., food, spice, or beverage supplies, technical assistance such as food preparation techniques). Collaborative partnerships could also be encouraged between academia, industry, and other key constituents such as the stakeholders in the setting of the research (e.g., worksites, schools and universities). Examples of research focusing on nutritional behaviors and obesity that could be conducted using PPP models include the subquestions listed.

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

Voting

54 net votes
96 up votes
42 down votes
Active

Goal 2: Reduce Human Disease

Regeneration of Failing Heart while Resting on Left Ventricular Assist Device

Heart transplant is the ultimate treatment for AHA stage-D heart failure. Due to availability, heart transplants will be limited to about 2,500 per year. Patients with AHA stage-D heart failure has estimated prevalence of 0.2% for age >45. Thus, patients in need far exceed organs available. A failed heart has very challenging environment for cellular therapy. Left ventricular assist device (LVAD) can offload the heart ...more »

Submitted by (@ctong0)

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 : Carl Tong

Voting

-4 net votes
3 up votes
7 down votes
Active

Goal 2: Reduce Human Disease

Physical activity of COPD patients

How can we increase physical activity in our COPD patients?

Submitted by (@nhlbiforumadministrator)

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 : American Thoracic Society member

Voting

3 net votes
3 up votes
0 down votes
Active