The Greater Cincinnati/Northern Kentucky NETT Network Hub and Spoke System

描述(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是巨大的。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实际上并不为人所知，部分原因是美国的临床研究企业并没有把重点放在研究疾病进展的早期阶段的干预措施上。在如此高的风险和紧迫的时间范围内进行疾病疗法的多中心临床试验，将需要对临床试验科学的许多方面进行创新思维和重新设计。为了提高效率和速度，神经急诊治疗试验(NETT)网络将要求急救第一线的临床医生和提供者建立本地基础设施，以便有效地招募患者参加各种神经急救试验。通过这一应用，我们建议成为RFA-NS-06-009神经紧急情况治疗试验(NETT)网络临床站点中心中描述的中心之一。我们将在辛辛那提大学医学院的高效、可扩展的中心和辐条系统的丰富经验的基础上发展。这一结构的关键要素包括一支由急诊医生、神经学家、神经外科医生、神经放射科医生、理疗师、院前提供者、儿科医生、创伤外科医生和重症医生组成的跨学科团队，所有这些人都在进行紧急临床试验方面具有特定的专业知识。我们的中心和分支系统具有强大的招生能力，特别是能够在我们的大型学术中心以及我们的社区医院急诊科招收患者。此外，我们还可以访问患者的整个人口统计范围以及神经疾病过程的所有范围。我们得到了临床医生、管理人员的支持和强大的公众宣传。我们将扩大我们已经证明的网络，准备执行为神经急诊治疗试验网络(NETT)提出的各种试验。我们将成为一支强大的力量，将患者招募到NETT网络参与的广泛的急性神经学临床试验中。

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 enormous. 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 actually known, in part because the clinical research enterprise in the United States has not been oriented toward studying interventions in the earliest phases of disease progression. Conducting multicenter clinical trials of therapies for illnesses with such high stakes and contracted time scales will require innovative thinking and redesign of many aspects of the science of clinical trials. To be effective and fast, The Neurological Emergencies Treatment Trials (NETT) Network will require the clinicians and providers at the front lines of emergency care to create local infrastructures that can effectively recruit patients into trials across the spectrum of neurological emergencies. With this application we propose to become one of the Hubs described in the RFA-NS-06-009 Neurological Emergencies Treatment Trials (NETT) Network Clinical Site Hubs. We will build upon our extensive prior experience with our highly effective, scalable Hub and Spoke system based out of the University of Cincinnati, College of Medicine. The key elements of this structure include an interdisciplinary team of emergency physicians, neurologists, neurosurgeons, neuroradiologists, physiatrists, pre-hospital providers, pediatricians, trauma surgeons, and intensivists all with specific expertise in the conduct of emergent clinical trials. Our Hub and Spoke system has tremendous enrollment capabilities and specifically has the ability to enroll patients in both our large academic center as well as our community hospital emergency departments. In addition we have access to the entire span of the patient demographic as well as the gamut of neurological disease processes. We have the support of clinicians, administrators and a strong public outreach. We will expand on our already proven network to be ready to perform the diverse trials brought forward for the Neurological Emergencies Treatment Trials (NETT) Network. We will be a powerful force in recruitment of patients into the broad spectrum of acute neurological clinical trials that are engaged by the NETT Network.