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 amid the chaos.
Kaweah Delta Health Care District, through the Office of Research and Grants, has been selected as one of eight locations where for the next five years, clinical trials will take place in an attempt to improve clinical outcomes for patients with neurologic, cardiac, respiratory, hematologic and traumatic emergencies.
“Research at Kaweah Delta is in the big leagues. Not only are we participating in multicenter studies, a good percentage of our resident doctors are doing research and other scholarly projects under the supervision of their faculty,” said Vicken Totten, M.D. Institutional Research Director at Kaweah Delta. “Together we are searching for ways to improve the care of our patients.”
Oregon Health Sciences University has chosen Kaweah Delta as one of the sites to conduct its clinical trials for the National Institutes of Health’s SIREN or Strategies to Innovate Emergency Care Clinical Trials Network. The network of 11 national hubs all have spokes – emergency departments across the country – which are working together to gain valuable insight in a way that would be impossible to do otherwise.
Oregon Health Sciences University is one of the 11 hubs. Each hub has a number of spokes or sub-Hubs. Kaweah Delta Health Care District was selected as a spoke for OHSU. In addition to Kaweah Delta, OHSU will conduct trials at 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, and University of Rochester Medical Center.
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.
“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,” Sun said.
Daya and other emergency medicine researchers at OHSU have been involved with clinical trials for over 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 receive $160,000 in the first year, followed by $98,000 in each of the next four years to establish and coordinate research. 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.”
Research is supported by the National Institute of Neurological Disorders and Stroke of the NIH under Award Number U24NS100657. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Kaweah Delta is a publicly-owned community healthcare organization that provides comprehensive health services to the greater Visalia region and Tulare County.