Clinical And Imaging Core Support Of Acute Stroke Research

急性卒中研究项目的基础是急性卒中临床服务，它将确保最大限度的患者转诊，并允许快速识别、筛选和招募潜在的研究对象，及时研究脑损伤的早期事件，并将患者纳入急性卒中研究方案。由于缺乏急诊科，NIH临床中心无法作为我们研究项目的主要地点。因此，我们建立并维护了当地医院的临床、影像和研究基础设施，以支持这项研究：马里兰州贝塞斯达的郊区医院（SH）和华盛顿特区的MedStar华盛顿医院中心（MWHC）。这些地点也是我们ACGME认可的血管神经学奖学金培训项目和招募创伤性脑损伤研究方案的关键培训地点。该基础设施的主要组成部分包括NIH中风服务，这是NIH和承包商临床医生中风神经科医生、护士、临床研究员、现场研究/护士协调员和MRI技术人员的结合。NIH的计算机网络已经扩展到每个站点。此外，NIH在MWHC放置了一台3T MRI扫描仪，并在SH共享一台3T MRI扫描仪。我们维护自己的PACS，用于MWHC和SH MRI扫描仪上获得的图像，并开发和维护临床和研究患者数据的注册表。

The foundation of an acute stroke research program is an acute stroke clinical service that will assure maximum patient referral and allow rapid identification, screening and recruitment of potential research subjects in the timely fashion needed to study the early events in cerebral injury and enroll patients in acute stroke research protocols. Absence of an emergency department has precluded the NIH Clinical Center as the main site of our research projects. Thus, we have established and maintained the clinical, imaging and research infrastructure required to support this research at local hospitals: Suburban Hospital (SH) in Bethesda, Maryland, and MedStar Washington Hospital Center (MWHC) in DC. These sites also serve as the key training locations for our ACGME accredited vascular neurology fellowship training program and for recruitment into the traumatic brain injury research protocols. The major elements of this infrastructure include the NIH Stroke Service, a combination of NIH and contractor clinicians stroke neurologists, nurses, clinical fellows, on-site research/nurse coordinators and MRI technologists. The NIH computer network has been extended to each site. In addition, NIH has placed a 3T MRI scanner at MWHC and shares a 3T MRI scanner at SH. We maintain our own PACS for images obtained on the MWHC and SH MRI scanners, and developed and maintain a registry for clinical and research patient data. The coronavirus pandemic continues to impact the program over the entire year. Enrollment into research was paused due to COVID-19 pandemic, however we successfully reopened the study, with all research activities beginning in October 2020. Enrollment and follow-up have not been without challenges, however the program has adapted and our recruitment and retention number are on par with pre-pandemic levels.