Arizona Neurological Emergencies Treatment Trials Network

描述(由申请人提供)：由急性神经疾病和损伤引起的紧急情况很常见，这些情况给患者和社会带来的健康负担有很好的记录。许多神经疾病的结果通常在发病后的第一分钟内确定，急诊科甚至在急诊科到达之前进行干预可能是必要的，以提供有意义的好处。针对这些疾病的最佳治疗方法没有得到很好的描述，部分原因是美国的临床研究没有针对治疗的早期阶段进行许多干预试验。调查人员面临的另一个障碍是能否招募到足够数量的志愿者，以便在测试干预措施时获得统计学意义。为了克服这些挑战，美国国立神经疾病和中风研究所(NINDS)努力创建一个由大型和社区医院组成的广泛网络，称为“中心辐射”模式。这一模式寻求捕捉广泛的社会人口概况，包括少数群体和服务不足的个人，同时避免临床试验中隐含的旷日持久的时间表。NINDS已经选择密歇根大学急诊医学系作为临床协调中心，并将确定一个数据协调地点。我们的团队将通过整合来自亚利桑那州两个大都市区的三家主要医院和四家乡村医院，为这个网络做出重大贡献。亚利桑那州神经紧急情况治疗试验网络(AzNETT)的中心和辐条设计将得到加强，纳入已经包括在亚利桑那大学远程医疗计划中的乡村医院。通过不断增长的基础设施，我们将能够在更广泛的服务环境中调查新疗法的有效性，同时努力提高患者护理的质量。这一结构的关键要素将包括一个由急诊医生、神经学家、神经外科医生、协调员、项目经理和信息技术专家组成的跨学科团队，他们在进行紧急临床试验方面具有特定的专业知识。中心和分支站点的团队成员都表现出了长期致力于推进国家研究基础设施，因为这与紧急疾病的跨学科研究有关。

DESCRIPTION (provided by applicant): Emergencies caused by acute neurological disorders and injuries are common and the health burden of these conditions to patients and society is well documented. The outcome of many neurological disorders is often determined within the first minutes after onset and intervention in the emergency department or even prior to emergency department arrival may be necessary to provide meaningful benefit. The optimal treatments for these conditions are not well described, in part because the clinical research in the United States has not conducted many intervention trials targeting the earliest phases of treatment. Another obstacle facing investigators is the ability to enroll a sufficient number of volunteers to obtain statistical significance in testing the intervention. To overcome these challenges, the National Institutes of Neurological Disease and Strokes (NINDS) endeavors to create a wide network of major and community hospitals, referred to as the "hub and spoke" model. This model seeks to capture a wide socio-demographic profile including minority and underserved individuals, while obviating protracted timelines implicit in clinical trials. NINDS has selected the Department of Emergency Medicine at the University of Michigan as the Clinical Coordinating Center, and a data coordinating site will be identified. Our team will contribute significantly to this network by incorporating three major hospitals from Arizona's two metropolitan areas and four rural hospitals. The hub and spoke design of the Arizona Neurological Emergencies Treatment Trials Network (AzNETT) will be enhanced by incorporating rural hospitals already included in the University of Arizona's Telemedicine Program. Through this growing infrastructure, we will be able to investigate the effectiveness of new therapies in a broader range of service environments, while striving to augment the quality of patient care. The key elements of this structure will include an interdisciplinary team of emergency physicians, neurologists, neurosurgeons, coordinators, program managers and information technologists with specific expertise in the conduct of emergent clinical trials. Team members in both the hub and spoke sites have demonstrated a long term commitment to advancing the national research infrastructure as it relates to the interdisciplinary study of emergent illness.