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

描述（由申请人提供）：急性神经系统疾病和损伤引起的紧急情况很常见，这些疾病对患者和社会的健康负担是巨大的。许多神经系统疾病的结果通常在发病后的最初几分钟内确定，在急诊室或甚至在急诊室到达之前进行干预可能是必要的，以提供有意义的益处。这些疾病的最佳治疗方法实际上并不清楚，部分原因是美国的临床研究企业并没有致力于研究疾病进展最早阶段的干预措施。针对风险如此之高、时间尺度如此之短的疾病进行多中心临床试验，需要创新思维，并重新设计临床试验科学的许多方面。为了有效和快速，神经系统紧急情况治疗试验（NETT）网络将要求紧急护理第一线的临床医生和提供者创建本地基础设施，以便有效地招募患者参加各种神经系统紧急情况的试验。通过此应用程序，我们建议成为RFA-NS-06-009神经系统紧急情况治疗试验（NETT）网络临床研究中心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、可扩展的轴辐式系统的丰富经验基础上再接再厉。这种结构的关键要素包括急诊医生、神经科医生、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监护医生的跨学科团队，他们都具有开展紧急临床试验的特定专业知识。我们的中心和辐条系统具有巨大的招生能力，特别是有能力在我们的大型学术中心以及我们的社区医院急诊科招收病人。此外，我们可以访问整个跨度的病人人口统计以及色域的神经系统疾病的过程。我们得到了临床医生、管理人员和强大的公众宣传的支持。我们将扩大我们已经证明的网络，准备执行为神经系统紧急情况治疗试验（NETT）网络提出的各种试验。我们将成为招募患者参加NETT网络参与的广泛急性神经学临床试验的强大力量。

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.