Initiative for Multicenter Pragmatic Anesthesiology Clinical Trials (IMPACT) Award

This award was established by leaders of academic anesthesiology organizations that recognized there was a need to conduct large pragmatic trials in order to answer important questions in anesthesiology-related research. Although there are several successful anesthesiology clinical trial networks around the world, one did not previously exist in the United States. In an attempt to address this important opportunity, a consortium of academic anesthesiology organizations launched an initiative in 2018 to stimulate pragmatic research in the U.S. in collaboration with our colleagues in Canada, the Canadian Perioperative Anesthesia Clinical Trials Group (PACT), and elsewhere. This effort was conceptualized and endorsed by a few key organizations, which had as a common goal the advancement of knowledge in anesthesiology and the enhancement of care in perioperative medicine, critical care, pain management, and peri- and post-partum care. These organizations included:

These organizations joined together and established a program to support the development of proposals for pragmatic clinical trials by anesthesiology investigators for submission to external funding sources, such as the NIH. By working together, they sought to improve the quality of the proposals and increase the prospects of securing funding.

Over the course of its initial two years, IMPACT awarded seed funding ($15,000 USD each) to six promising projects to develop a formal proposal for large scale trials.

For the 2020 grant cycle, based upon learnings from the initial award cycles and the larger context of pragmatic trials in anesthesiology medicine, three major changes were made to the IMPACT award criteria. Greater focus was placed on:

  1. early and mid-career principal investigators;
  2. enabling a pilot / feasibility study essential for the successful planning and funding of pragmatic trials;
  3. clear prioritization of pragmatic rather than explanatory trials.

Additional requirements included that applicant principal investigators be clinically active anesthesiologists within ten years of their initial faculty appointment to a Department of Anesthesiology. Next, rather than distributing funds to three different projects to enable grant preparation, a single award in the amount of $50,000 USD funded a feasibility trial in preparation for the design of a multicenter pragmatic clinical trial. Finally, while the value of explanatory randomized controlled trials is clear, the focus for IMPACT became pragmatic trials, as assessed by the PRECIS-2 tool.

The revised IMPACT program also included an opportunity for input and advice from knowledgeable sources, along with a $50,000 grant to enable a pilot or feasibility trial in preparation for the design of a multicenter pragmatic clinical trial.

Past Recipients

Matthieu Legrand, MD, PhD
The choice of vasopressors for treating hypotension during General Anesthesia : a pilot pragmatic cluster cross-over randomized trial (the VEGA-1 trial)
Professor in Residence
Department of Anesthesia and Peri-operative Care
University of California, San Francisco
Karim Ladha, MD
The Comparison of Analgesic Regimen Effectiveness for Surgery (CARES) Trial
Assistant Professor & Staff Anesthesiologist
Department of Anesthesia and Pain Medicine
University Health Network, Toronto General Hospital

David Mazer, MD
TRICS IV-Restrictive versus Liberal Transfusion in Younger Patients Undergoing Cardiac Surgery
Associate Scientist & Professor
St Michael’s Hospital, Toronto

Robert Schonberger, MD, MHS
Improving population health via the surgical encounter: Targeting underuse of statins
Associate Professor
Yale University – School of Medicine

Michael Aziz, MD
Optimized Opioid Management or Usual Treatment to Reduce Persistent Opioid Use Following Surgery (OPT-OUT).
Professor
Anesthesiology & Preoperative Medicine
Oregon Health & Science University

Randall Blank, MD, PhD
Individualized Intraoperative Protective Ventilation using an Open Lung Approach with Driving Pressure Limitation.
Associate Professor of Anesthesiology
Chief, Thoracic Anesthesia
Department of Anesthesiology
University of Virginia Health System

Frederic T. (Josh) Billings IV, MD, MSc
Intraoperative Normoxia versus Hyperoxia during Maintenance Anesthesia to Reduce Postoperative Complications.
Associate Professor of Anesthesiology and Medicine
Co-director, BH Robbins Scholars Physician-Scientist Development Program
Vanderbilt University

2020
Matthieu Legrand, MD, PhD
The choice of vasopressors for treating hypotension during General Anesthesia : a pilot pragmatic cluster cross-over randomized trial (the VEGA-1 trial)
Professor in Residence
Department of Anesthesia and Peri-operative Care
University of California, San Francisco
2019
Karim Ladha, MD
The Comparison of Analgesic Regimen Effectiveness for Surgery (CARES) Trial
Assistant Professor & Staff Anesthesiologist
Department of Anesthesia and Pain Medicine
University Health Network, Toronto General Hospital

David Mazer, MD
TRICS IV-Restrictive versus Liberal Transfusion in Younger Patients Undergoing Cardiac Surgery
Associate Scientist & Professor
St Michael’s Hospital, Toronto

Robert Schonberger, MD, MHS
Improving population health via the surgical encounter: Targeting underuse of statins
Associate Professor
Yale University – School of Medicine

2018
Michael Aziz, MD
Optimized Opioid Management or Usual Treatment to Reduce Persistent Opioid Use Following Surgery (OPT-OUT).
Professor
Anesthesiology & Preoperative Medicine
Oregon Health & Science University

Randall Blank, MD, PhD
Individualized Intraoperative Protective Ventilation using an Open Lung Approach with Driving Pressure Limitation.
Associate Professor of Anesthesiology
Chief, Thoracic Anesthesia
Department of Anesthesiology
University of Virginia Health System

Frederic T. (Josh) Billings IV, MD, MSc
Intraoperative Normoxia versus Hyperoxia during Maintenance Anesthesia to Reduce Postoperative Complications.
Associate Professor of Anesthesiology and Medicine
Co-director, BH Robbins Scholars Physician-Scientist Development Program
Vanderbilt University