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 3: Advance Translational Research

Genome Profiling

There is a need to facilitate the integration of genomic and epigenomic profiling into drug discovery efforts by using genomic methods to sequence and analyze blood disease subtypes.

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

Details on the impact of addressing this CQ or CC

Despite the important information that has been generated from sequencing studies in various blood disorders, for many hematologic disease subtypes, the limited scope of sequencing and the insufficient number of cases sequenced has prevented researchers from gaining truly useful insights. Whole-genome sequencing of large numbers of samples, with an emphasis on poorly studied and rare entities, is required to fully define the landscape of genetic changes underlying the development of blood diseases. Further, genetic and epigenetic alterations that drive hematologic diseases and the extent to which normal cells are distinct from malignant cells needs to be more broadly elucidated since many blood diseases, including hematopoietic cancers, disturb epigenetic regulators. The knowledge gained from understanding these processes and integrating genomic and epigenomic profiles could provide additional precision medicine opportunities and guide drug discovery efforts.

Name of idea submitter and other team members who worked on this idea Alice Kuaban on behalf of the American Society of Hematology

Voting

0 net votes
16 up votes
16 down votes
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Goal 3: Advance Translational Research

Engineering Challenges for Next Generation VADs

Critical challenges to overcome include the development of non-platelet activating impellers and hypothrombogenic surfaces in modern ventricular assist devices (VADs). Percutaneous and transcutaneous electric drive systems will need to evolve, and clinical research is needed to reduce thromboembolism and bleeding (acquired von Willebrand syndrome). Adverse events may also be further reduced if smaller pumps, for partial... more »

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 improve quality of life for VAD recipients by reducing or eliminating their need to lifelong anticoagulant medication.

Feasibility and challenges of addressing this CQ or CC

There have been steady incremental improvements in all the challenge areas, and there are already many patients who do not encounter problems. A convergence and focusing of research efforts is needed.
Use of modern ventricular assist devices (VADs) has been associated with improvements in survival. However, INTERMACS has revealed that many of the adverse events associated with VADs stem from bio-incompatibilities between the device and patient.

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

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6 net votes
27 up votes
21 down votes
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Goal 2: Reduce Human Disease

Neuroendocrine system in heart and lung disease

What is the role of the non-neuronal neuroendocrine system in lung and heart pathophysiological processes, and can it be targeted for lung diseases therapies?

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

3 net votes
13 up votes
10 down votes
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Goal 3: Advance Translational Research

T4 Implementation Research Platform in Low Income Countries

What are the best strategies to stimulate development of a T4 Implementation Research network within low income countries (LICs)?

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

Details on the impact of addressing this CQ or CC

• Currently there are huge implementation challenges within LIC contexts and only limited progress is being made to address the gaps
• Conducting research in the context where its finding will be scaled up will vastly increase its appropriateness, adoption and uptake, fidelity, and sustainability
• Small improvements in the challenging context of LICs should provide opportunities to make a large burden reduction

Feasibility and challenges of addressing this CQ or CC

• Currently there are formative efforts to engage biomedical research in LICs with H3Africa, Global Alliance for Chronic Diseases, and others
• NHLBI Think Tanks and Workshops have found much interest and demand to T4 Implementation research engagement
• Key non-traditional partners (World Bank, USAID) are working on implementation strategies in LICs currently and will be strong partners

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

Voting

-22 net votes
7 up votes
29 down votes
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Goal 2: Reduce Human Disease

Management strategies for severe, asymptomatic aortic stenosis

What is the optimal management approach to severe asymptomatic calcific aortic stenosis (surgical aortic valve replacement (AVR) or deferred surgical AVR until development of symptoms (watchful waiting))?

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

Details on the impact of addressing this CQ or CC

Several non-randomized, retrospective analyses suggest early surgery results in improved survival but significant controversy remains. Answering this compelling question will clear up this conundrum of clinical management in this prevalent disease.

Feasibility and challenges of addressing this CQ or CC

It is feasible to answer this question over the next 5-10 years because the disease is prevalent and growing with the aging population and there is equipoise within the medical community about current management options.

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

Voting

6 net votes
14 up votes
8 down votes
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Goal 2: Reduce Human Disease

Improving the phenotyping of the major (chronic) heart, lung, and blood diseases

Which phenotypic and molecular characteristics predict differential responses to therapy in individuals with chronic heart, lung, blood, and sleep (HLBS) diseases?

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

Details on the impact of addressing this CQ or CC

• Enable pathophysiologically targeted therapies and prevention
• Enable subgroup assessment of intervention
• Better define gene-gene and gene-environment interactions
• Improve risk stratification
• Understand those who are protected against disease
• Inform development of better in vitro and in vivo models to assess disease and response

Feasibility and challenges of addressing this CQ or CC

Advances in –omics, diagnostics, cell biology, imaging are ready to be applied

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

Voting

30 net votes
42 up votes
12 down votes
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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.

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 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 »

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

Voting

-4 net votes
5 up votes
9 down votes
Active

Goal 2: Reduce Human Disease

Condom with Retention Means And Shield (Patent Pending)

Condom designed to protect a males pubic areas and scrotum, fingers and hands from coming in contact with infectious fluids. The adoption of a shield to reduce the occurrence of HPV and other STI infections. This is the first and only condom in the world that uses a latex shield which is designed to protect a promiscuous males fingers and hands from HPV and other infectious human secretions that may be in fluids,. We... more »

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

Details on the impact of addressing this CQ or CC

Changing the course of the AIDS epidemic can be done with this condom. https//:www.indiegogo.com/projects/condom-getting-physical-with-stds We all wear latex glove when handling things that may infect us and we all wear latex glove to make sure any "foul matter" like infectious blood or viruses, germs and bacterias do not get on our hands. Some men are promiscuous and are getting infectious fluids, "foul matter" on their pubic areas, scrotum, fingers, hands and baseline. The social impact of not building a better condom and preventing HPV and other STI includes illnesses, infertility, adverse pregnancy outcomes, lost work and unnecessary health care costs in the billions of dollars.

Feasibility and challenges of addressing this CQ or CC

Latex condom: This is a male condom which can be used by a female as a female controlled safe method "Female Condom". This condom exceeds the sanitary and hygiene requirement and standards which make it problematic for condom companies. What would happen to the current value of the traditional condom.

Name of idea submitter and other team members who worked on this idea Alexander Ward

Voting

-43 net votes
1 up votes
44 down votes
Active

Goal 2: Reduce Human Disease

Molecular effects of ischemia and reperfusion

What is the impact of total body ischemia and reperfusion on coagulation, inflammation, and endothelial function?

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 AHA Staff & Volunteers

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-4 net votes
1 up votes
5 down votes
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Goal 4: Develop Workforce and Resources

Pharmacy-Physician Cross-Reference System Required

Why does a cross-reference gap occur when prescriptions are filled through a patient's one and only pharmacy. How can a pharmacist double check a physician's work when the physician prescribes a medication that should NOT be taken if the patient has a diagnosis the pharmacist has no documented evidence to REJECT the prescription and NOT dispense the dangerous drug-interaction, drug vs. medical condition information? Since... more »

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

Details on the impact of addressing this CQ or CC

#1) Tramadol/Ultram was prescribed by hospital discharging physician #1. Prescription paperwork clearly stated that Tramadol should not be administered if you take Cymbalta/Duloxetine. I took Tramadol and Cymbalta together for two (2) years.

#2) Seroquel/Quentiamine (generic name ??) was prescribed by physican #2. Prescription paperwork indicates this drug should NOT be taken with the drug SOTALOL/BETAPACE or patients who have Prolonged Q-T Interval or Long QT. I have Long QT and the pharmacist's response to filling the Seroquel prescription, which made me ill, was the Seroquel dose was not too high. That pharmacy also fills my Sotalol.

#3) I have been allergic to sulfa drugs. Physician #3 prescribed Polymyxin B Sulfate and Trimethoprim Ophthalmic Solution USP. I was initially prescribed the eye drops on 04-02-2015. Because my left eye continued to bother me, I returned to the same urgent care. I have a Medtronic ICD (implantable cardioverter defibrillator). Medical records clearly indicate that Sulfa drugs affect my cardiovascular system. On 04-14-2015, I returned to the same urgent care for eye pain but, based on my abnormal ECG, cardiovascular was my primary reason for the visit, not my eye. I was told to resume the Polymyxin (full eye drop name above).

I didn't find out this data until just recently. If the pharmacist KNEW I had Long QT, perhaps Seroquel would have NEVER been filled, which harmed my conditions.

Feasibility and challenges of addressing this CQ or CC

Based on the above information, how can pharmacist's double check the doctor's (unfilled) prescriptions without knowledge of the patient's health history? How could a pharmacist fill a drug Seroquel when it shouldn't be combined with Sotalol or those with Long QT? How can this drug-interaction be avoided? How do we fill the gap? I am a serious disabled person who has exhausted herself because she HAS HAD to become a self-appointed, her OWN HEALTH ADVOCATE.

Name of idea submitter and other team members who worked on this idea Louise Companion

Voting

-10 net votes
0 up votes
10 down votes
Active

Goal 1: Promote Human Health

Emerging importance of RNA regulation

What are the roles of RNAs (e.g., microRNAs, long non-coding RNAs, etc.) in myocardial growth, adaptation, and injury healing response?

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

Details on the impact of addressing this CQ or CC

As an example, recent studies suggest key regulatory roles of RNAs (e.g., microRNAs and long non-coding RNAs) in cardiac pathological hypertrophy and heart failure. Better understanding of such mechanisms will spur development of new therapies based on these mechanisms.

Feasibility and challenges of addressing this CQ or CC

Most of the infrastructure and methods are in place. There appears to be growing interest and excitement about the potential of this research area. However, this field needs more researchers.

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

Voting

4 net votes
18 up votes
14 down votes
Active

Goal 4: Develop Workforce and Resources

Preparing a Diverse Biomedical Technology Development Workforce

How do we best develop a scientific workforce that is fluent in product development and commercialization issues? How can NHLBI best expand the training opportunities for early career scientists to prepare them for entry into the dynamic biomedical workforce landscape? There is a need for scientifically-trained experts from diverse backgrounds who also understand business needs relevant to biomedical technology development,... more »

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

Details on the impact of addressing this CQ or CC

A well-trained biomedical technology development workforce would enhance the quantity and quality of research translated from the lab to the market focused on heart, lung, blood, sleep indications. A better understanding of the product development pathway would improve efficiency and resource usage, and accelerate the time for products to reach the market. Structured training would better prepare academic scientists for industry collaboration and provide an industry-ready scientific workforce. Ensuring these training opportunities are inclusive of scientists from different backgrounds would increase the diversity of the biomedical technology development workforce.

Feasibility and challenges of addressing this CQ or CC

Industry is a large employer of research trainees, and trainees are becoming increasingly vocal about their interest in opportunities to be trained in areas beyond the academic lab that would prepare them for roles in industry. NHLBI can leverage recently launched educational opportunities, including the BEST (Broadening Experiences in Scientific Training), NCAI (NIH Centers for Accelerated Innovations), REACH (Research Evaluation And Commercialization Hubs), and CTSA (Clinical and Translational Science Awards) programs.
Transitioning scientific discoveries to inventions and products to benefit public health requires knowledge and education beyond what is traditionally learned during medical, graduate, and post-doctoral training.

Challenges to addressing this CQ include:

• Need for educators and mentors with relevant industry experience and expertise.

• This would be a culture shift in academic institutions, though the new NIH programs described above has already started to influence this shift.

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

Voting

0 net votes
19 up votes
19 down votes
Active