First annual Arnar-Stone lecture: The importance of the endocrine and metabolic responses to shock and trauma.

Trauma and shock result in activation of a wide variety of endocrine and metabolic systems. Based upon experimental work demonstrating metabolic deficits, a variety of metabolic therapies have been developed to assist in the treatment of patients with shock or trauma. Evidence to date is inconclusive as to whether this therapy will be of significant benefit to critically ill patients. Some of the senior author's previous research has been analyzed as it relates to important health policy issues. We suggest that a peer review mechanism be set up within organized professional groups to assess major research trends and develop informed opinions on key research subjects within their domain. These peer review assessments must be effectively communicated to Congress and the executive branch of the government, as well as to the general public, if support commensurate with the importance of the research is to be achieved.