Neurological emergencies comprise a wide range of conditions which include refractory seizures, acute stroke, traumatic brain and spinal cord injury, meningitis and encephalitis, hypoxic-ischemic encephalopathy, and acute neuromuscular conditions. While these may initially appear to represent disparate conditions, they share two important characteristics: earlier treatment is likely necessary to improve patient outcome and logistics of initial patient presentation pose major challenges to clinical trials of treatments fo these conditions. The NINDS Neurological Emergencies Treatment Trials Network has created a national network of hub and spoke hospital systems to facilitate the conduct of streamlined clinical trials for neurological emergencies such as these. SF-NETT: the San Francisco Neurological Emergencies Trials network has been a high-enrolling hub-spoke system during the first 5-year NETT cycle. SF-NETT represents a scalable and flexible network which can be configured and activated to maximize enrollment of eligible patients across a wide range of conditions being studied. Consisting of all San Francisco ambulance destination hospitals, as well as three specially selected geographically non-contiguous spokes (UCSF-Fresno, Queen's Medical Center, and UC Davis), SF-NETT represents a consortium of academic and community hospitals with a catchment population exceeding 4 million. San Francisco General Hospital is a trauma center, stroke center, the SF-EMSA base hospital, and serves as the hub of SF-NETT. Between the hub and participating spoke hospitals, there are 4 designated trauma centers, 7 comprehensive stroke centers, and 4 EMS systems. SF-NETT works directly with NINDS and the NETT Clinical Coordinating Center to conduct multiple concurrent clinical trials of neurological emergencies via the network, with four trials initiated (one completed) during the initial 5-year cycle. This application is for the 5-year renewal of SF-NETT as a hub for the national NETT network.

Public Health Relevance

Neurological emergencies such as refractory seizures, stroke, and neurotrauma have a major impact on public health and are the challenging conditions to study because of the need for early intervention. The NETT network has proven to be an efficient system in which to conduct these trials and SF-NETT has been a high-enrolling active hub during the initial 5-year program cycle.

Agency
National Institute of Health (NIH)
Institute
National Institute of Neurological Disorders and Stroke (NINDS)
Type
Cooperative Clinical Research--Cooperative Agreements (U10)
Project #
5U10NS058931-08
Application #
8726493
Study Section
Special Emphasis Panel (ZNS1-SRB-N (01))
Program Officer
Janis, Scott
Project Start
2007-05-03
Project End
2017-05-31
Budget Start
2014-06-01
Budget End
2015-05-31
Support Year
8
Fiscal Year
2014
Total Cost
$309,303
Indirect Cost
$113,645
Name
University of California San Francisco
Department
Neurology
Type
Schools of Medicine
DUNS #
094878337
City
San Francisco
State
CA
Country
United States
Zip Code
94143
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