Mid-America Regional Coordinating Center (MARCC)

中风是美国的一个主要公共卫生问题，在美国，它是第五大死亡原因， 成人残疾的主要原因。因此，非常需要开展转化和临床研究， 预防、治疗或促进中风后恢复的干预措施。然而，临床试验需要大量的 基础设施，以及为单个试验组装这种基础设施所需的时间和精力是一个主要的问题。 进步的障碍。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批准和合同协议来最大限度地提高效率。与 一个国家临床协调中心（NCC），一个国家数据管理中心（DMC），以及25个 在美国各地的区域协调中心（RCCs），StrokeNet的建立是为了有效地招募和 招募患者进行中风试验。中西部的密苏里州（MO）和堪萨斯（KS）没有代表 在中风网络的前一个周期。然而，密苏里州的中风患病率排名第4，中风死亡率排名第9， 在美国，堪萨斯也不甘落后。在这里，我们提出了一个建议，发展中美洲区域 华盛顿大学医学院和附属Barnes-Jewish协调中心（MARCC） 医院，与其他三个高容量三级护理中风中心合作，跨越中西部 密苏里州、堪萨斯州和伊利诺伊州：密苏里州堪萨斯城的圣卢克医院;圣路易斯大学医院（SLU）。 路易斯，密苏里州;和圣弗朗西斯医疗中心在皮奥里亚，IL的顺序。每个医疗中心都是一个三级医疗中心 拥有大型转诊医院网络的护理中心，并拥有参与多中心护理的丰富经验 中风试验因此，MARCC是“网络的网络”。从农村和城市环境中汲取经验， MARCC每年收治近5,000名中风患者，包括来自不同种族背景的患者， 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小组， 参与MARCC的人员具有各种专业知识，可以在整个 翻译和治疗谱。我们建议设立的25个乡郊协调中心之一，包括 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。目标2.为了有效地进行NINDS StrokeNet试验， 通过MARCC进行中风预防、治疗和康复。目标3：招募和培养未来的临床医生- 通过奖学金培训和职业发展，帮助中风研究的科学家。

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.