Advanced Surgical Center for Translational Research at Dartmouth

描述(由申请人提供)：目前的按服务收费的医疗保健制度给临床翻译研究带来了极大的压力，特别是在外科手术室和成像套房等高成本、创收设施中进行的活动。这些设施依赖于程序效率和空间节约来最大限度地提高患者吞吐量。转化性研究对于开发新的临床技术和程序以及评估临床结果是必不可少的；然而，在当前的卫生保健环境中进行转译研究变得越来越困难，因为它对临床工作流程具有极大的破坏性。为了应对这一挑战，并提供关键的基础设施来支持达特茅斯公司在与成像和图像引导干预以及外科观察和结果研究相关的临床转化研究方面的卓越领域，我们建议创建高级外科中心，这是一个专门的研究设施，由两个手术室组成，其术中成像系统可在相邻的诊断套件之间移动。这一新的研究基础设施将(A)加强国家认可的神经外科和整形外科研究计划，(B)利用同样资金充足的神经成像和乳房成像研究，在介入心理治疗和手术切除指导的术中生物标记物方面催生创新的新计划，以及(C)加强前列腺外科、术中血氧成像和活体光学显微镜方面的新兴研究计划。一旦建成并完全发挥作用，ASC将提供先进的成像、图像引导和数据收集工具，这些工具将用于证实和/或验证医学发现、临床假说和程序创新。手术方式将包括术中MR、CT、超声、光学成像和其他新的测量技术。这项建议代表着一个非同寻常的机会，可以在地方、地区和国家经济受到压力，从而导致用于此类基础设施项目的机构资源不足的情况下，通过ARRA刺激基金来维护和扩大达特茅斯的临床转化研究承诺。通过这份C06提案申请了1000万美元的费用，用于建设设施所需的建设资金和固定(非科学)设备，同时还要求机构承诺安装使ASC充分运行所需的商业成像和手术设备以及非固定仪器。拟议的倡议将通过授予创建新设施所需的建筑合同，在新罕布夏州和该地区立即产生经济刺激。作为这些计划的结果，我们还预计，我们在翻译研究方面已经广泛的NIH赠款组合将出现增长，这将带来新的就业机会，进而为NH经济的复苏和可持续性做出贡献。

DESCRIPTION (provided by applicant): The current fee-for-service health care system places extraordinary pressures on clinical translational research, especially activities which take place in high-cost, revenue generating facilities such as surgical operating rooms and imaging suites. These facilities rely on both procedural efficiencies and space economies to maximize patient throughput. Translational research is essential to developing new clinical technologies and procedures as well as for evaluating clinical outcomes; yet, has become increasing difficult to conduct in the current health-care environment because it is highly disruptive to clinical workflow. To address this challenge, and provide critical infrastructure to support Dartmouth's areas of excellence in clinical translational research associated with imaging and image-guided interventions and surgical observational and outcomes studies, we propose to create the Advanced Surgical Center, a dedicated research facility consisting of twin operating theaters with intraoperative imaging systems that move between adjoining diagnostic suites. This new research infrastructure will (a) enhance nationally-recognized research programs in neurosurgery and orthopedic surgery, (b) leverage similarly well-funded research in neuro-imaging and breast imaging to spawn innovative new programs in interventional psycho-therapeutics and intraoperative biomarkers for surgical resection guidance, and (c) augment emerging research programs in prostate surgery, intraoperative oximetry imaging and in vivo optical microscopy. Once completed and fully functional, the ASC will offer advanced imaging, image-guidance and data collection tools, which will be used to substantiate and/or validate medical discoveries, clinical hypotheses and procedural innovations. Modalities will include intraoperative MR, CT, ultrasound, optical imaging, and other novel measurement technologies. This proposal represents an extraordinary opportunity to preserve and amplify Dartmouth's clinical translational research commitment through the ARRA stimulus funds at a time when the local, regional, and national economies are stressed, and when, as a result, institutional resources for such infrastructure projects are inadequate. Costs of $10M are being requested through this C06 proposal for the construction funds and fixed (non-scientific) equipment necessary to create the facility, accompanied by an institutional commitment to install the commercially available imaging and surgical equipment and non-fixed instruments necessary to make the ASC fully operational. The proposed initiative will create immediate economic stimulus within the State of New Hampshire and the region through the awarding of the construction contracts necessary to create the new facility. As a result of these plans, we also expect growth in our already extensive NIH grant portfolio in translational research, which will lead to new jobs that will in turn contribute to the recovery and sustainability of the NH economy.