Neurological Emergencies Treatment Trials (NETT) Network Clinical Site Hubs

描述(由申请人提供)：急性神经性疾病，相对于其对社会的影响，一直研究得很少。其中许多神经问题需要紧急评估和治疗，最好是由多学科团队进行。NETT网络的建立就是为了解决这些问题，因为发现和实施有效的神经紧急治疗方法将需要从大规模临床试验中衍生出复杂的研究方案。这一计划的成功不仅取决于一个协调良好的中央数据管理中心，而且还取决于有能力在大量人口中紧急招募患者的中心和分支站点。该计划的广泛和长期目标是测试和制定新的有效治疗神经紧急情况的方法，并改善美国人的整体健康状况。项目设计是一个中央协调枢纽(部门)的设计。韦恩州立大学(WSU)急诊医学系)在紧急病人护理和基于紧急情况的临床试验方面拥有成熟的专业知识。Spokes“(底特律医疗中心和William Beaumont医院)提供：i)从板凳到床边的神经科学专业知识，2)招募患者参加紧急介入试验的公认能力，3)覆盖密歇根州东南部的广泛人群的50多万急诊科就诊，4)医院间、部门间和跨学科合作的悠久历史。罗伯特·韦尔奇博士与布莱恩·奥尼尔博士一起，拥有一群令人羡慕的合作伙伴，其中包括成人和儿科急救内科医生、神经学家、神经外科医生、重症护理专家和创伤外科医生。威斯康星州立大学的“中心”在紧急干预试验方面拥有丰富的经验，这些试验在院前启动，并在急诊科、医院和康复阶段持续进行。西澳州立大学的研究人员已经成功地让患者参加了院前干预试验RES-Q、PAD、Polyheme、DCAR、POST和脑血氧仪试验。此外，这些研究人员还领导了各种紧急介入试验的入选患者，如RESPECT、TIA-ADP、PECARN、ONO-REPACT、BADHIT、GEN-IMS、ProAction和RESPECT-ACS。在每一次试验中，我们的站点都超出了预期，并向主要调查人员提供了大量高质量的干净数据。其中一些研究需要征询社会人士的意见才能实施。西澳州立大学的网站配备了一个集成和复杂的电子病历系统，将医院网站连接起来。该系统具有先进的远程医疗能力，进一步增强了患者评估和咨询。NETT网络将进行研究，最终将导致S神经急诊的新的有效治疗。这些新的治疗方法将传播给执业医生和他们的病人，并将改善公众的健康和生活。

DESCRIPTION (provided by applicant): Acute neurologic disorders, relative to their effect on society, have been very poorly studied. Many of these neurological problems require emergent evaluation and treatment, ideally by a multi-disciplinary team. The NETT network has been established to address just these issues as the discovery and implementation of effective treatments for neurological emergencies will require sophisticated study protocols derived from large-scale clinical trials. The success of this initiative hinges not only on a well-coordinated central data management center, but also on hub and spoke sites that have the competence to enroll patients emergently across a large demographic. The broad and long-term goal of this program is to test and institute new effective therapies for neurological emergencies and improve the overall health of Americans. The project design is that of a central coordinating "Hub" (Dept. of Emergency Medicine, Wayne State University - WSU) which has proven expertise in emergency patient care and emergency based clinical trails. The "Spokes" (Detroit Medical Center and William Beaumont Hospitals) offers: i) expertise in the neurosciences from the bench to the bedside, 2) proven competency in enrolling patients into emergent interventional trials, 3) over 500,000 emergency department visits across a wide demographic that blankets Southeast Michigan and 4) a long history of inter-hospital, interdepartmental and interdisciplinary collaboration. Dr Robert Welch, in conjunction with Dr. Brian O'Neil, has an enviable group of established collaborators that include both adult and pediatric emergency medicine physicians, neurologists, neurosurgeons, critical care specialists and trauma surgeons. The WSU "Hub" has a breadth of experience in emergent intervention trials initiated pre-hospital and continued throughout the emergency department, hospital and rehabilitation phases. WSU investigators have successfully enrolled patient in the pre-hospital interventional trials Res-Q, PAD, PolyHeme, DCAR, POST and Cerebral oximetry trials. Furthermore the same investigators have been leaders in enrolled patients in various emergent interventional trials such as RESCUE, TIA-ADP, PECARN, ONO-REACT, BADHIT, Gen-IMS, PROACTION, and RESCUE-ACS. In each of these trials our sites have exceeded expectations and provided high volume and high quality clean data to the principal investigators. A number of these studies required community consultation for implementation. The WSU site is equipped with an integrated and sophisticated electronic medical record system that links hospital sites. The system has advanced telemedicine capabilities, which further augments patient evaluations and consultation. The NETT Network will perform research studies that will ultimately result in new and effective treatment s of neurological emergencies. These new treatments will be disseminated to practicing doctors and their patients and will improve the health and lives of the public.