UA College of Medicine - Tucson selected for NIH initiative to advance critical emergency medicine research

The University of Arizona College of Medicine - Tucson is one of a team of six national institutions selected for the Strategies to Innovate EmeRgENcy Care Clinical Trials Network (SIREN), a new initiative of the National Institutes of Health to advance critical emergency medicine research.

A clear need exists for research to improve emergency care and clinical outcomes, according to the NIH. Data published by the U.S. Centers for Disease Control and Prevention show that in 2011 there were 136 million emergency department (ED) visits in the United States, accounting for about 4 percent of all health-care spending. Of these visits, 12 percent, or some 16 million, resulted in a hospital admission.

SIREN provides infrastructure for large multi-site clinical trials to improve outcomes for patients with neurologic, heart, lung, blood and trauma emergencies, in all stages of emergency care, from pre-hospital emergency medical services to hospital EDs, trauma systems and emergency operative interventions. SIREN will allow rigorous comparative effectiveness studies and assessments of novel therapies.

Charles B. Cairns, MD, FACEP, FAHA, dean of the UA College of Medicine - Tucson, will serve as principal investigator for the UA "hub" of the SIREN collaborative team. A nationally recognized leader in emergency and critical care research, Dr. Cairns also is a professor in the UA Department of Emergency Medicine.

"The UA College of Medicine - Tucson has a vast set of resources and assets to successfully implement and complete research in the entire spectrum of emergency care," said Dr. Cairns. "The UA Emergency Medicine Research Center - Tucson is home to the Southwest Research Node Center, one of six U.S. Research Node Centers for the Pediatric Emergency Care Applied Research Network. In addition, we have been part of the NIH Neurological Emergencies Treatment Trials Network for many years. Further, the internationally noted UA respiratory, cardiac and trauma research programs bring unique expertise to the SIREN network."

The collaborative SIREN grant was awarded to a team of highly experienced research investigators from six institutions: Emory University (PI David Wright, MD), Brown University (PI Lisa Merck, MD MPH), Tufts University (PI Harry Selker, MD, MSPH), University of Texas Health Science Center at Houston (PI Elizabeth Jones, MD), Orlando Regional Medical Center (PI Linda Papa, MD) and the UA.

The investigators will function as a CORE-EM (COalition for REsearch in Emergency Medicine) Hub Alliance. The CORE-EM is one of 11 NIH SIREN-funded clinical hubs in the nation, all sharing infrastructure funding and working together on large (greater than 1,000-patient) clinical trials to be awarded under separate funding announcements. The CORE-EM Hub Alliance is funded by a grant from the NIH National Institute of Neurological Disorders and Stroke, project No. 1U24NS100673-01.

Each of the six hubs of the CORE-EM will have a network of satellite clinical sites, or "spokes," overseen by the hub PI. The UA College of Medicine - Tucson hub will have five spokes: Banner - University Medical Center Tucson, Banner - UMC South, Banner - UMC Phoenix, Chandler Regional Medical Center, HonorHealth Scottsdale Osborn Medical Center and Maricopa Medical Center.

"A unique aspect of our SIREN research infrastructure is the UA partnership with Banner Health," noted Dr. Cairns. "Clinical research has been part of Banner Health's portfolio since its inception and Banner has invested more than $100 million for research. Recently, UA and Banner have developed a joint investigator portal that provides access to an integrated data warehouse, identifies mentoring resources and integrates timely contract, regulatory and financial review. As a result, our partnership has enabled us to successfully compete for large NIH clinical and program project grants, including the NIH Precision Medicine Initiative."

The UA SIREN hub includes accomplished clinician-researchers with diverse areas of expertise from across the UA Health Sciences. The hub's co-PIs include: Kurt Denninghoff, MD, lead co-PI, associate director of the UA Emergency Medicine Research Center - Tucson and PI for the Southwest Research Node Center of the Pediatric Emergency Care Applied Research Network (PECARN); Daniel Spaite, MD, the Virginia Piper Distinguished Chair of Emergency Medicine and PI of the EPIC study, the largest NIH emergency medical services (EMS) study of pre-hospital head injury; Karl Kern, MD, director of the UA Sarver Heart Center Resuscitation Research Group, which spearheaded decades-long research in resuscitation, developing chest-compression-only CPR; Chelsea Kidwell, MD, vice chair of research, UA Department of Neurology, and an NIH-funded stroke investigator; and Bellal Joseph, MD, professor of surgery, director of trauma research and PI of Department of Defense and Defense Advanced Research Projects Agency (DARPA)-funded trials of trauma and head injury.

Other key leaders include: Bentley Bobrow, MD, medical director of the Arizona Department of Health Services' Bureau of Emergency Medical Services & Trauma System and associate director of the UA Emergency Medicine Research Center - Phoenix; Leigh Neumayer, MD, UA interim senior vice president for health sciences; Monica Kraft, MD, chair, UA Department of Medicine and NIH-funded researcher in asthma and airway disease; and Fernando Martinez, MD, director, UAHS Asthma and Airway Disease Research Center and NIH-funded investigator in pediatric asthma.

SIREN is the successor network of the NIH Neurological Emergencies Treatment Trials Network (NETT) and the NIH Resuscitation Outcomes Consortium (ROC). NETT clinical trials now will be conducted through SIREN, including the current "Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke (POINT)" and the "Stroke Hyperglycemia Insulin Network Effort (SHINE)" trials being conducted at the UA.

The 11-clinical hub SIREN network includes: Emory University; Massachusetts General Hospital; Medical College of Wisconsin; Oregon Health Sciences University; Temple University; University of California, Los Angeles; University of Cincinnati; University of Minnesota; University of Pittsburgh; University of Washington; and Wayne State University.

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