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New NIH-funded research hub focuses on emergency care

OHSU among 11 hubs nationwide selected to participate in clinical trial initiative
OHSU Emergency
OHSU Emergency Department. (OHSU/Kristyna Wentz-Graff)

A hospital emergency department may not seem the most likely place to perform a clinical trial. Loud, stressful and chaotic, the American emergency room offers a tried-and-true backdrop for television and motion picture productions but is not typically considered the domain of painstaking academic research.

However, physicians will attest that important life-saving research can take place amidst the chaos.

Add together emergency departments across a network of dozens or even hundreds of hospitals around the country, and it’s possible to gain valuable insight in a way that would be impossible to do otherwise. To that end, OHSU has been selected by the National Institutes of Health as one of 11 national hubs to coordinate clinical trials in emergency medical care nationwide.

The program is known as SIREN, or Strategies to Innovate Emergency Care Clinical Trials Network.

Benjamin Sun, M.D.
Benjamin Sun, M.D. (OHSU/Kristyna Wentz-Graff)
Mohamud Daya, M.D.
Mohamud Daya, M.D. (OHSU/Kristyna Wentz-Graff)

Mohamud Daya, M.D., and Benjamin Sun, M.D., both professors of Emergency Medicine in the OHSU School of Medicine, are the grant recipients who will be coordinating the research hub for the five-year duration of the program. OHSU’s hub-spoke network includes outstanding research institutions from across the country.

“We’re working closely with strong academic institutions,” Sun said. “What we find may change medical practices across the country, and we know that academic medical centers are committed to finding the best way of managing emergency health care.”

Daya and other emergency medicine researchers at OHSU have been involved with clinical trials for more than a decade, and this new network allows researchers to test clinical practices through randomized double-blind control trials – the gold standard of medical research. The large scale and wide geographic distribution allows clinicians to draw conclusions about uncertain medical interventions that are currently assumed to be of equal benefit. For example, emergency physicians administering medications for seizures will now be able to compare recovery rates for patients treated with one FDA-approved drug against another.

“The challenge has always been, how do you do research in an emergency care setting,” Daya said. “Now, we should be able to complete the highest-level studies in acute, life-threatening circumstances.”

Each of the 11 hub sites will receive $160,000 in the first year, followed by $98,000 in each of the next four years to establish and coordinate research. The goal is to improve clinical outcomes for patients with neurologic, cardiac, respiratory, hematologic and traumatic emergencies. With an increasing number of patients seeking treatment in emergency departments nationwide, the research hubs should begin to quickly amass statistically valid comparisons between treatment options.

“A hundred or 200 patients is not enough, but if you can get into the hundreds or thousands of patients enrolled in a trial, you can come up with definitive answers,” Daya said. “The only way to answer these questions is by doing large randomized clinical trials.”

The OHSU SIREN network includes the University of Alabama Medical Center, the University of Wisconsin Medical Center, the University of Utah Medical Center, Duke University Medical Center, Ohio State University Medical Center, Wake Forest Baptist Health, University of Rochester Medical Center, and Kaweah Delta Health Care.

Research is supported by the National Institute of Neurological Disorders and Stroke of the National Institutes of Health under Award Number U24NS100657. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

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