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The specific objectives of TACTIC are to:
1. Compare trauma patient coagulation & outcomes in response to different existing transfusion strategies.  
The first study tasks encompass the establishment and analysis of an international trauma registry of prospective patient cohort data, and a linked biobank of samples already collected from 2000 patients at sites across Europe. Comparing current data from all the study centres, we will correlate patient morbidity, as well as mortality and data on health care costs with the different local treatment regimens and identify key parameters for sensitive outcome measurement (to support future clinical studies; WP8). To complement pre-existing functional coagulation data, we will conduct biochemical assays on the patient samples to elucidate at the molecular level the response of the body’s coagulation system to transfusion.
2. Specify the different disease profiles and specific mechanisms underlying TIC.
 
In parallel to Objective 1, TACTIC will use viscoelastic haemostatic assays (VHA) to define clinical parameters by which we can rapidly identify and characterise different subgroups of coagulopathic patients. In conjunction with the registry datasets describing patient’s functional coagulation status, mechanism & severity of injury and physiological condition, we will describe TIC-specific biomarker profiles and genetic determinants. This will ascertain the early signalling that initiates the onset of adverse physiological responses to injury, and ultimately outcomes (e.g. coagulopathy, organ dysfunction, sepsis), thereby providing opportunities for innovative therapeutic intervention.  
3. Develop personalised strategies for targeted transfusion therapy.
 
Year 1 will enable the rapid diagnosis of different sub-groups of TIC and provide the evidence to best describe changes in a patient’s clotting system (both at the functional and molecular level), when transfused with doses of blood components and procoagulants. This will provide a mechanism for the development of personalised, evidence-based targeted treatment algorithms to correct TIC. This will minimise both the wastage of valuable therapeutic resources and their potentially unnecessary and harmful administration.
4. Compare existing practices with the personalised, targeted treatment of TIC. 
TACTIC will conduct a 2-year multi-centre study to compare personalised targeted treatment with existing empiric transfusion practice. This comparative randomised control trial and accompanying health economic model will demonstrate whether the evidence-based, targeted and personalised treatment of TIC leads to enhanced patient outcomes and is more cost-effective than existing consensus (i.e. opinion-led) practice.  
5.
Deliver guidelines and support for the clinical management of coagulopathic bleeding. 
The treatment of TIC and trauma haemorrhage is complex and often occurs in patients in extremis. In Year 1, TACTIC will for the first time assimilate pan-European comparative evidence to determine and compare costs and outcomes associated with existing treatment strategies. Thereafter (Years 3-5) the programme will conduct a European multicentre randomised control trial that will deliver universal guidelines for the treatment of coagulopathic bleeding, whether the evidence proves empiric or targeted transfusion most optimal.
In parallel TACTIC will also ‘connect’ VHA measures of functional clotting to the on-going molecular perturbation of the patient’s coagulation system, in response to both injury and haemostatic resuscitation. The enablement of a dynamic visual interface will also serve to support treating clinicians in the rapid dynamic course of emergency care by highlighting factors for immediate attention, thereby minimising life-threatening mistakes in patient management.  
More information: www.tactic.dana6.dk
The TACTIC project is co-funded by the European Commission under the HEALTH-Contract No. F3-2013-602771