SF-NET: San Francisco Neurological Emergencies Trials Network

描述（由申请人提供）：神经急症包括范围广泛的疾病，包括难治性癫痫发作、急性中风、创伤性脑和脊髓损伤、脑膜炎和脑炎、缺氧缺血性脑病和急性神经肌肉疾病。虽然这些最初看起来可能代表不同的疾病，但它们有两个重要特征：早期治疗可能是改善患者预后所必需的，并且患者初始表现的后勤对这些疾病治疗的临床试验构成了重大挑战。国家神经疾病研究所的神经急症治疗试验网络将建立一个全国中心和辐状医院系统网络，以促进对诸如此类的神经急症进行简化的临床试验。我们建议SF-NET：旧金山神经紧急试验网络作为这些中心和辐条系统之一。SF-NET代表了一个可扩展和灵活的学术和社区医院网络，可以配置和激活，以最大限度地招收旧金山湾区符合条件的神经急症患者，完全覆盖多达200万人的集水区，具体取决于要研究的具体情况。SF-NET直接建立在先前在旧金山进行的神经紧急情况临床试验的成功基础上，最突出的是通过与SF-EMSA护理人员和救护车服务协调的类似网络进行的癫痫持续状态院前治疗（PHTSE）试验。旧金山总医院是创伤中心、中风中心、SF-EMSA基地医院，也是SF-NET的中心。Spoke医院包括旧金山的所有八家SF-EMSA目的地医院，所有这些医院以前都参加过PHTSE，以及阿拉米达县医疗中心高地医院，奥克兰的创伤中心，以丰富SF-NET的神经创伤。SF-NET将直接与NINDS和NETT临床协调员中心合作，通过该网络开展至少2项神经急症临床试验。神经紧急情况，如难治性癫痫发作、中风和神经创伤，对公共卫生有重大影响，由于需要早期干预，是具有挑战性的研究条件。一个针对这些疾病进行简化试验的网络可以更快地为临床护理带来新的治疗方法。

DESCRIPTION (provided by applicant): Neurological emergencies comprise a wide range of conditions which include refractory seizures, acute stroke, traumatic brain and spinal cord injury, meningitis and encephalitis, hypoxic-ischemic encephalopathy, and acute neuromuscular conditions. While these may initially appear to represent disparate conditions, they share two important characteristics: earlier treatment is likely necessary to improve patient outcome and logistics of initial patient presentation pose major challenges to clinical trials of treatments for these conditions. The NINDS Neurological Emergencies Treatment Trials Network will create a national network of hub and spoke hospital systems to facilitate the conduct of streamlined clinical trials for neurological emergencies such as these. We propose SF-NET: the San Francisco Neurological Emergencies Trials network as one of these hub and spoke systems. SF-NET represents a scalable and flexible network of academic and community hospitals which can be configured and activated to maximize enrollment of eligible patients with neurological emergencies in the San Francisco Bay Area, completely covering a catchment area of up to 2 million people depending on the specific condition to be studied. SF-NET builds directly upon the prior successes of clinical trials for neurological emergencies conducted in San Francisco, most prominently the Prehospital Treatment of Status Epilepticus (PHTSE) trial which was conducted via a similar type of network in coordination with SF-EMSA paramedic and ambulance services. San Francisco General Hospital is a trauma center, stroke center, the SF-EMSA base hospital, and serves as the hub of SF-NET. Spoke hospitals include all eight SF-EMSA destination hospitals in San Francisco, all of which previously participated in PHTSE, as well as Alameda County Medical Center Highland Hospital, the trauma center in Oakland, included to enrich SF-NET in neurotrauma. SF-NET will work directly with NINDS and the NETT Clinical Coordinator Center to conduct at least 2 clinical trials of neurological emergencies via the network. Neurological emergencies such as refractory seizures, stroke, and neurotrauma have a major impact on public health and are challenging conditions to study because of the need for early intervention. A network to conduct streamlined trials for these conditions can bring new treatments to clinical care more rapidly.