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Comments on the past and predictions on the future of neonatal research – consortia, randomized cluster trials, brain care centres and xenon
I will discuss the background of how ideas for research projects evolve. This is a topic that researchers rarely explain. It is obviously very important. Unfortunately, editors rarely, if ever, request that such material be included in publications. My friend, Dr Mary Ellen Avery, Professor at Harvard University, suggested the subject to me and intended to write such an article herself. Unfortunately, she never did. I will discuss the birth of three good ideas I have had over a long career in neonatology, from 1952 to 2011! These were phototherapy, the Vermont Oxford Network and helping to organize large, international randomized control trials of xenon. I am now 85 years old, long past the age you are supposed to have ‘hot’ ideas, but I think I have important ideas about the future. It is my belief that brain care, brain cooling plus some other agents are the future. Proving this, however, will take reorganization of our current ways of carrying out clinical research. It is my personal belief, based on the basic research to date, that xenon gas is likely to be successful. To prove this ‘idea’, our field needs to reorganize into large consortia. It will probably take a decade or longer to prove this hypothesis by carrying out the necessary, very large, randomized trials. We need to encourage neonatologists to unite and work together on new advances.