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 2: Reduce Human Disease

Vascular Anomalies

Vascular anomaly research is currently making exciting advances but discovery is hampered by lack of funding and collaborative prospective studies

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 Dr. Denise M Adams and Paula Mobberley-Schuman

Voting

3 net votes
7 up votes
4 down votes
Active

Goal 2: Reduce Human Disease

What types of questions are most likely to improve the health of the public? The importance of discovery science.

Congressional eagerness to see research funding translate into improvements in health care may make studies that address “how-to-deliver-care-questions” seem attractive. But the answers to “how–questions” are often so context dependent that the findings are neither generalizable nor durable. The answers to “how–questions” too often become obsolete when the health-care system, the electronic medical record, or the insurance... 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

Improvement in the health of the public.

Feasibility and challenges of addressing this CQ or CC

It is easily a matter of focus.

Name of idea submitter and other team members who worked on this idea Psaty & Tracy

Voting

22 net votes
29 up votes
7 down votes
Active

Goal 1: Promote Human Health

Investigating Co-Morbidities in Women's Cardiovascular Health

There are important questions related to the cardiovascular health of women, and particularly to diagnostic and therapeutic challenges arising from the common existence of co-morbid conditions. The latter consideration, as well as the limitations of the budgets of individual institutes and centers at the NIH, suggest that it may be reasonable for the NHLBI to consider cross-NIH collaborations with I/Cs that have related... 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

Collaboration across I/Cs could encourage investigators or teams to explore new concepts underlying the etiology of common or rare cardiovascular diseases (CVD), including stroke, particularly those with gender-related differences. In addition, clinical research on these disorders would benefit from active consideration of the common co-morbidities seen in patients with CVD, especially as patients with these co-morbidities are often specifically excluded from clinical trials. Since the patients who will ultimately benefit from treatments developed will often suffer from multiple other disorders, the societal benefit would be substantial. While any single I/C could support such studies, collaborative funding would be likely to bring together new teams of investigators with novel ideas.

Feasibility and challenges of addressing this CQ or CC

We believe that there is likely to be a good response from investigators, both basic and clinical, to collaborative, multi-I/C RFAs. It might be of additional benefit to provide some funds specifically for teams that are newly collaborative in response to the RFAs, to encourage increased cross-field collaboration.

Name of idea submitter and other team members who worked on this idea Rose Marie Robertson for American Heart Association

Voting

3 net votes
3 up votes
0 down votes
Active

Goal 2: Reduce Human Disease

Diaphragmatic dysfunction in critical illness

Diaphragmatic dysfunction occurs more frequently than clinically recognized in the setting of acute critical illness or injury. This contributes to both incipient and prolonged respiratory failure, as well as the growth of long-term acute care/rehab hospitalizations. We need a better understanding of the mechanisms of dysfunction as well as strategies to mitigate loss of diaphragmatic muscle mass, ultimately leading... 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

This problem can be addressed through a combination of Integrative physiology and real-time data analytics.

Feasibility and challenges of addressing this CQ or CC

Patients receiving critical care services in the United States are among the most close monitored, including continuous monitoring of cardiorespiratory physiology. Integrating high dimensional data from ICU data streams and applying big data analytics, in combination with primetime genomic and metabolomic technologies, makes answering this question imminently feasible.

Name of idea submitter and other team members who worked on this idea Society of Critical Care Medicine Executive Committee/Council

Voting

-1 net votes
1 up votes
2 down votes
Active

Goal 2: Reduce Human Disease

Mechanics of aortic dissection

The mechanical events in the wall leading to aortic dissection are not well described because merely stating that cellular or biopolymer connections have weakened does not predict the path of the rupture through the media or the risk of rupture. Elucidate the mechanical role of substructures such as collagen fibers, elastin sheets, smooth muscle cells and interstitial fluid in the progression of dissection. Study in animal... 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

While in recent years the lives of patients with aortic dissection have increasingly been saved, an understanding of the mechanisms involved might suggest new techniques to increase the percentage who survive aortic dissection.

Feasibility and challenges of addressing this CQ or CC

Knowing the mechanisms involved in dissection is more important than attempting to determine and measure some critical rupture stress because of the large differences between specimen aortas within a given species.

Name of idea submitter and other team members who worked on this idea Henry W. Haslach, Jr.

Voting

7 net votes
17 up votes
10 down votes
Active

Goal 3: Advance Translational Research

Sickle Cell Trait complications

What are the factors leading to severe health consequences in the sickle cell trait population?

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

Details on the impact of addressing this CQ or CC

It has been reported for many decades that the sickle cell trait population are an asymptomatic group; however, there have been an increasing number of reports in the media and the medical literature suggesting the opposite.

Name of idea submitter and other team members who worked on this idea Sickle Cell Warriors, Inc. community members

Voting

30 net votes
38 up votes
8 down votes
Active

Goal 3: Advance Translational Research

Chronobiology in Chronic Lung Diseases

In the new era of once a day inhalers for Asthma and COPD, there is critical need to determine whether delivery of drugs to the lung at night or day have different therapeutic effects and/or side effect profile.

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

Details on the impact of addressing this CQ or CC

Understanding whether a delivery of a LAMA, LABA and/or ICS at different times of the day has a potential critical impact in symptom control and preservation of lung function

Feasibility and challenges of addressing this CQ or CC

This question can ben addressed via the use of Pragmatic Clinical Trials.

Name of idea submitter and other team members who worked on this idea Alejandro Comellas

Voting

11 net votes
22 up votes
11 down votes
Active

Goal 2: Reduce Human Disease

Optimal hemoglobin threshold for transfusion in children with ARDS?

Do different hemoglobin transfusion thresholds alter outcomes in children with ARDS? What is the optimal *minimum* transfusion threshold for children with ARDS? What patient-centered outcomes can be affected by transfusion strategies: ventilator free days, time to organ function recovery, duration of intensive care stay, survival?

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 Society of Critical Care Medicine Executive Committee/Council

Voting

8 net votes
9 up votes
1 down votes
Active

Goal 2: Reduce Human Disease

What defines COPD disease severity?

What defines COPD disease severity?

a. Spirometric classification is inadequate

b. Patient-centered outcomes should be central to this classification

c. The need for suitable instruments

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

4 net votes
4 up votes
0 down votes
Active

Goal 2: Reduce Human Disease

HEALTH CARE DISPARITIES IN DIAGNOSIS AND TREATMENT OF COMMON SLEEP AND CIRCADIAN DISORDERS

There is evidence of a higher prevalence of sleep and circadian disorders in different ethnic groups. This is true for both adult and pediatric subjects. There is also evidence that minority populations in lower socioeconomic groups do not seek evaluation for sleep disorders as frequently as other segments of our population. There is also evidence that they are less adherent to treatments such as nasal CPAP for obstructive... 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

Sleep disorders are more common in minority populations. Moreover, these populations have higher rates of the known consequences of these disorders such as stroke, myocardial infarction, hypertension, resistant hypertension. Despite this, current population studies such as the Sleep Heart Health Study have included only a very small percentage of African Americans. The impact of this would be the following:

a. Elucidating the basis of barriers to case identification in these group
b. Designing specific intervention to overcome these barriers.
c. Developing methods to improve adherence to therapy in this group.
d. Removing sleep and circadian disorders as a risk factor for consequences such as stroke, cardiovascular disease and resistant hypertension in minority populations

Feasibility and challenges of addressing this CQ or CC

There is a developing interest in this area in the field of circadian and sleep research. There is a developing knowledge base about health disparities in sleep and circadian disorders. Minority institutions such as Morehouse have developing programs in this area. We also have mobile technology that facilitates study of sleep and circadian disorders in minority populations.

Name of idea submitter and other team members who worked on this idea Sleep Research Society

Voting

118 net votes
163 up votes
45 down votes
Active

Goal 3: Advance Translational Research

Incentivizing Translational Research

Support for scientific research depends on making a compelling case that we contribute to the health of Americans and the health of the US economy. This idea is to address the critical challenge of making basic research relevant to the lives of Americans by incentivizing NHBLI researchers to engage meaningfully in translational research.

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 specific proposal is to give a 5 to 10 percentile bump (similar to that given to junior investigator) to researchers whose NIH funding has led to translational outcomes that are of tangible benefit to the health of Americans and/or the US economy.

Categories that would meet the translational bump might include:

  1. A clinical trial based on their basic or clinical research;
  2. Generation of a device, drug or other therapy that has entered cllinical testing;
  3. Granting of a patent that has been licensed by a company,

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

Voting

16 net votes
25 up votes
9 down votes
Active

Goal 3: Advance Translational Research

Genome Editing and Gene Therapy

There is a critical need for the establishment of strategies that will determine the efficacy, safety, and toxicity of genome editing techniques specifically in hematologic diseases.

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

Details on the impact of addressing this CQ or CC

Inherited monogenic hematologic diseases such as hemophilia, beta-thalassemia and sickle cell disease are prime targets for future application of genome editing technology. However, studies are still needed to advance our understanding of the biology of genome editing as well as determine which other disorders are amenable to genome editing correction. Emphasis on preclinical research that focuses on determining the accuracy, safety and efficiency of this technology in order to help minimize off-target mutations and reduce toxicity, is essential for effective translation of this technology into the clinic. Once preclinical efficacy is established, support will be needed for clinical vector production, toxicity testing of the vectors/reagents used, and the performance of clinical trials. The gene correction strategies developed for inherited disorders will also be attractive for other hematologic diseases, and autoimmune disorders like lupus, rheumatoid arthritis, and type I diabetes). There is also a critical need for supporting preclinical validation studies, scale-up and GMP cell manufacturing, all of which could be shared infrastructures across multiple diseases in the NHLBI portfolio.

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

Voting

69 net votes
87 up votes
18 down votes
Active

Goal 3: Advance Translational Research

Vascular Anomalies

Vascular anomaly research is currently making exciting advances but discovery is hampered by lack of funding and collaborative prospective studies

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 Dr. Denise M Adams and Paula Mobberley-Schuman, MS

Voting

2 net votes
5 up votes
3 down votes
Active