Military Perspectives on Brain Injuries: Implications on Clinical Trials

Abstract Military medical providers rely on civilian medical research to advanced care. The clinical practice guidelines developed for civilian practice is used by the military. Similarly, the same journals, expert panel reviews, and so on are all used by military medicine. However, due largely to limited civilian interest, there are specific medical conditions for which the Department of Defense (DoD) must itself conduct or sponsor. Examples of these conditions are hemorrhagic shock, explosive blast traumatic brain, malaria, and others. For many military patients, the highest level of care will be a medic, who may be required to render care for prolonged periods when evacuation is not possible. For these, the DoD will develop research programs that are conducted either by funding civilian medical scientists or engaging intramural DoD scientists. Importantly, the ethics and other rules of conduct regulating civilian medical research apply equally to the military scientists. These include all the typical human subject informed consent, animal use protocols, and review board approvals. For any human subject work done on behalf of the DoD, a second level of Human Use approval is required. DoD supported medical research, whether conducted on behalf of military or civilian patients, is meant to benefit everyone.