Mid-America Regional Coordinating Center (MARCC)

在美国，中风是一个主要的公共卫生问题，它是导致死亡的第五大原因，也是 成人残疾的主要原因。因此，迫切需要开展翻译和临床研究。 预防、治疗或促进中风后康复的干预措施。然而，临床试验需要显著的 基础设施，以及为个别试验组装这些基础设施所需的时间和精力是一个主要的 前进的障碍。NINDS StrokeNet成立于2013年，是一个国家中风试验基础设施， 旨在通过集中监管、IRB审批和合同协议最大限度地提高效率。使用一个 单一的国家临床协调中心(NCC)、单一的国家数据管理中心(DMC)和25 整个美国的区域协调中心(RCC)，StrokeNet的建立是为了高效地招募和 招募患者参加中风试验。中西部的密苏里州(密苏里州)和堪萨斯州(KS)没有代表出席 在StrokeNet的前一个周期中。然而，密苏里州的中风患病率排名第四，中风死亡率排名第九。 美国各州，堪萨斯州也紧随其后。在这里，我们提出了一项开发中美洲地区的建议 华盛顿大学医学院协调中心(MARCC)及其附属巴恩斯-犹太人 医院，与横跨中西部的其他三个大容量三级护理中风中心合作 密苏里州、肯塔基州和伊利诺伊州：密苏里州堪萨斯城的圣卢克医院；圣路易斯大学医院(SLU) 密苏里州路易斯市；伊利诺伊州皮奥里亚的圣弗朗西斯医疗中心修道会。这些医疗中心中的每一个都是 拥有大型转诊医院网络的护理中心，并有丰富的参与多中心工作的经验 中风试验。因此，MARC是一个“网络网络”。来自农村和城市的医院， 每年收治近5,000名中风患者，包括来自不同种族背景和 社会经济阶层。此外，中风临床医生、研究人员和科学家的集体团体将 参与Marcc拥有不同的专业知识，将允许在整个 转化谱和治疗谱。我们建议将MARC设立为25个农村信用社之一，具有以下条件 具体目标：目标1.建立和维护一个无缝的三州中风试验基础设施--中美洲 区域协调中心(MARC)。目的2.有效和高效地进行NINDS StrokeNet试验 通过MARC预防、治疗和康复中风。目标3.招募和培训未来的临床医生- 科学家通过团契培训和职业提升参与中风研究。

Stroke is a major public health problem in the United States, where it is the 5th leading cause of death and the leading cause of adult disability. Therefore, there is great need for translational and clinical research to develop interventions that prevent, treat, or enhance recovery after stroke. However, clinical trials require significant infrastructure, and the time and energy required to assemble this infrastructure for individual trials is a major barrier to progress. The NINDS StrokeNet was established in 2013 as a national stroke trials infrastructure, designed to maximize efficiencies by centralizing regulatory, IRB approval, and contractual agreements. With a single National Clinical Coordinating Center (NCC), a single National Data Management Center (DMC), and 25 Regional Coordinating Centers (RCCs) throughout the US, StrokeNet was established to efficiently recruit and enroll patients for stroke trials. The Midwestern states of Missouri (MO) and Kansas (KS) were not represented in the prior cycle of StrokeNet. Yet Missouri ranks 4th in stroke prevalence3 and 9th in stroke mortality4, among all states in the US, and Kansas is not far behind. Here we forward a proposal to develop the Mid-America Regional Coordinating Center (MARCC) at Washington University School of Medicine and affiliated Barnes-Jewish Hospital, in collaboration with three other high-volume tertiary care Stroke Centers spanning the midwestern states of MO, KS, and IL: St. Luke’s Hospital in Kansas City, MO; St. Louis University Hospital (SLU) in St. Louis, MO; and the Order of St. Francis Medical Center in Peoria, IL. Each of these medical centers is a tertiary care hub with large networks of referring hospitals, and have extensive experience participating in multi-center stroke trials. Thus, MARCC is a “Network of Networks.” Drawing from both rural and urban settings, the hospitals of MARCC admit almost 5,000 stroke patients per year, including patients from diverse racial backgrounds and socioeconomic strata. Moreover, the collective group of stroke clinicians, investigators, and scientists that will participate in MARCC have diverse expertise that will permit the implementation of stroke trials across the translational and treatment spectrum. We propose to establish MARCC as one of the 25 RCCs with the following specific aims: Aim 1. To establish and maintain a seamless tri-state stroke trials infrastructure—the Mid-America Regional Coordinating Center (MARCC). Aim 2. To effectively and efficiently conduct NINDS StrokeNet trials of stroke prevention, treatment and recovery through the MARCC. Aim 3. To recruit and train future clinician- scientists in stroke research through fellowship training and career enhancement.