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Opportunities for Emergency Medicine Researchers within the NIH CTSA Program


Harbor-UCLA Medical Center. Los Angeles Biomedical Research Institute ... University of Texas Health Science Center At San Antonio. University of Virginia ... – PowerPoint PPT presentation

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Title: Opportunities for Emergency Medicine Researchers within the NIH CTSA Program

Opportunities for Emergency Medicine Researchers
within the NIH CTSA Program
  • Roger J. Lewis, MD, PhD
  • Harbor-UCLA Medical Center
  • Los Angeles Biomedical Research Institute
  • David Geffen School of Medicine at UCLA

Funded CTSA Sites
  • Columbia University
  • Duke University
  • Mayo Clinic
  • Oregon Health Sciences University
  • Rockefeller University
  • University of California, Davis
  • University of California, San Francisco
  • University of Pennsylvania
  • University of Pittsburgh
  • University of Rochester
  • University of Texas, Houston
  • Yale University

52 Planning Grants
  • Brown University
  • Children's Research Institute
  • Dartmouth College
  • Emory University
  • Georgetown University
  • Harvard University Medical School
  • Howard University
  • Louisiana State University
  • Medical College of Georgia
  • Medical College of Wisconsin
  • Medical University of South Carolina
  • Meharry Medical College
  • Methodist Hospital Research Institute
  • Michigan State University
  • Mount Sinai School of Medicine
  • New York University School of Medicine
  • Stanford University
  • State University New York
  • Temple University
  • University of Cincinnati
  • University of Colorado at Denver and Health
    Sciences Center University of Connecticut School
    of Medicine
  • University of Florida
  • University of Hawaii at ManoaUniversity of
    Illinois at ChicagoUniversity of Kansas Medical
    CenterUniversity of KentuckyUniversity of
    LouisvilleUniversity of Maryland School of
    MedicineUniversity of Missouri-ColumbiaUniversit
    y of New MexicoUniversity of North Carolina at
    Chapel HillUniversity of North DakotaUniversity
    of Oklahoma Health Sciences Center
  • University of South Carolina at
    ColumbiaUniversity of South FloridaUniversity
    of Southern CaliforniaUniversity of Tennessee
    Health Science CenterUniversity of Texas Health
    Science Center At San Antonio
  • University of VirginiaUniversity of
    WashingtonUniversity of WisconsinVirginia
    Commonwealth UniversityWake Forest University
    Health SciencesWayne State UniversityWeill
    Medical College of Cornell University

Key Elements of the CTSA
  • Development of Novel Clinical and Translational
  • Pilot and Collaborative Translational and
    Clinical Studies
  • Biomedical Informatics
  • Design, Biostatistics, and Clinical Research
  • Regulatory Knowledge and Support
  • Translational Technologies and Resources
  • Participant and Clinical Interactions Resources
  • Community Engagement
  • Research, Education, Training, and Career

IOM Recommendations Research
  • 8.2a This study should include consideration of
    training of new investigators, development of
    multi-center research networks, funding of
    General Clinical Research Centers (GCRCs) that
    specifically include an emergency and trauma care
    component, involvement of emergency and trauma
    care researchers in the grant review and research
    advisory process, and improved research
    coordination through a dedicated center or

CTSA Sites and Activities
  • Sections of applications for 11 of 12 funded CTSA
    sites posted
  • Observations from searching those applications
    for the word emergency
  • Most occurrences of emergency are related to
    volume of patient visits, not research questions,
    scientific areas of focus, or even locations of
    subject recruitment

CTSA Sites and Activities
  • Finding the word emergency
  • Incorporation of emergency and trauma care
    research is highly variable across CTSAs
  • Rockefeller no emergency care site
  • OHSU high level of integration of emergency care
    activities and investigators

CTSA ExamplesUniversity of Rochester
  • Internal funding application E-cadherin in wound
  • Planned research Biomarkers for mild traumatic
    head injury
  • Applying for funds to initiate an emergency care
    research network in upstate New York, from the
    Upstate New York Consortium for Healthcare
    Research and Quality, the Upstate New York
    Translational Research Network, and the
    University of Rochester Clinical and
    Translational Sciences Institute.

CTSA ExamplesUniversity of Pennsylvania
  • Initially, little formal involvement of emergency
    medicine investigators
  • Discussing
  • Research training/fellowships
  • Utilization of CTRC with studies of emergency
    department patients
  • Participation in national emergency care sub
    network of CTSAs
  • Leveraging data collection programs developed in
    the emergency department

CTSA ExamplesOregon Health Sciences University
  • Department of Emergency Medicine contributed to
    fund for Human Investigation Program (HIP)
  • HIP statisticians collaborating with emergency
    care investigators
  • Existing Health Systems, Population, and
    Community-based research programs include active
    emergency care research programs and
  • Funded emergency care investigators serve as
    Oregon CTSI mentors
  • Participating in multi-center research consortia

CTSA ExamplesDuke University
  • Initially minimal involvement of emergency and
    trauma care investigators
  • Duke Translational Medicine Institute funded
    research ethics project entitled Bridging the
    gap participation in clinical research amongst
    minority populations submitted by emergency care

Training Nomenclature
Key Opportunities for EM Researchers
  • Training programs
  • Bring K30, K12, T32 and other research training
    programs into one structure
  • Intended to establish translational and clinical
    research as an academic discipline
  • Collaborative opportunities
  • Access to patients, key populations
  • Seed grants
  • Support to design, initiate, and gather
    preliminary data

Training How to Get Involved
  • Promising fellows and junior faculty may apply to
    CTSA training programs leading to masters in
    clinical and translational research type degrees
  • Theoretical and practical training
  • Access and exposure to mentors
  • Opportunities for collaboration

Training How to Get Involved
  • Both investigators and research staff may attend
    general research training programs
  • Regulatory knowledge
  • Practical skills
  • CRF design and pilot testing
  • Data collection and management
  • Adverse event (AE) reporting
  • Trial methodology/statistics

Collaboration Opportunities
  • Collaboration on multi- and inter-disciplinary
    research teams
  • Participating in clinical research networks
    (access to patients/visits)
  • Informing laboratory-based science and first
    phase of translation
  • Accelerating second-phase translational and
    clinical trials

Collaboration Added Value
  • Emergency care cuts across
  • Populations ethnic, racial, socioeconomic
  • Disease categories and severity
  • Acute, chronic, and stage of disease
  • Emergency care
  • Is fundamentally a form of outreach
  • May be the best setting to investigate early
    phases of disease (stroke, shock, etc.)

Collaboration Benefits
  • Establish your track record
  • Locally
  • Publications
  • Practical experience and knowledge
  • Access to key resources
  • Clinical laboratory
  • Research laboratories
  • Inpatient and outpatient facilities for follow-up
    data collection

Seed Grants
  • CTSAs have internal seed grant programs to
    stimulate exploratory, innovative studies
  • Provide resources for acquisition of preliminary
  • Allows demonstration of ability to perform
    research and publish results
  • Starts a funding track record
  • Above are generally required prior to successful
    applications for extramural funding

Emergency Care ResearchSub-network
  • Multiple disease-specific and discipline-specific
    research networks duplicate key infrastructure ?
    Cost effective?
  • CTSAs constitute a formal consortium
  • Potential to form an emergency care research
    sub-network within CTSAs raised at NIH
  • Builds on existing investment in infrastructure
    at each CTSA
  • Leverages existing expertise and personnel

Final Thoughts CTSA Institutions
  • Identify and enroll in CTSA training
    opportunities, both masters programs and short
  • Offer to donate effort and access to patients, if
    necessary, to establish collaborations and
    mentor-mentee relationships
  • Investigate seed grant programs, if qualified
  • Participate in ACEP-SAEM efforts to establish
    CTSA emergency care research network

Final Thoughts Planning Grant Institutions
  • Participate in grant application process,
    offering to help with sections
  • Participant and Clinical Interactions Resources
  • Community engagement
  • Other sections according to expertise
  • Identify EM trainees for clinical research
    training, if CTSA is funded
  • Plan on possible seed grant applications, if CTSA
    is funded

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