Asthma exacerbations account for almost 2 million emergency department (ED) visits in the United States each year. In response to this problem, the NHLBI recently convened a working group to encourage clinical research in emergency asthma. With the help of an administrative supplement to his K14 award, Dr. Carlos Camargo proposed to initiate such research in the ED at Massachusetts General Hospital (Boston, MA). Over the past 24 months, this local project has grown into the Multicenter Asthma Research Collaboration (MARC), a research network involving 77 urban EDS across North America. MARC investigators have completed several prospective cohort studies and are currently performing a multicenter randomized trial. The objective of this application is to obtain funding for a full-time statistician to help 77 MARC investigators to study the epidemiology of emergency asthma. Five representative aims are: to characterize acute asthma management in urban EDs, and then compare current practice with that recommended in the 1997 national guidelines; to examine gender differences in acute asthma; to identify reasons why minority patients with asthma go to (and possibly prefer) the ED for their asthma care; to characterize important clinical subgroups, such as acute asthma among pregnant women and patients with sudden-onset severe acute asthma; and to examine risk factors for asthma hospitalization and for relapse after ED discharge. The MARC investigators are in an excellent position to address these aims. The study has a better design (prospective cohort) than most prior ED studies. Also, the network approach has yielded a large sample size (n=2,464) with excellent statistical power. Another advantage is the age range (ages 2-54), which not only allows investigation of children but also comparison of pediatric findings with results from comparable analyses among adults. Another advantage is that the PI is a well-trained and experienced investigator who works regularly with much larger datasets and has access to many experts in the field. The proposal satisfies all criteria of the Small Grants Program, as well as the NIH Review Criteria. Thus, we are confident that analysis of the MARC databases would make an important contribution to current understanding of emergency asthma.

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Small Research Grants (R03)
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Clinical Trials Review Committee (CLTR)
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Massachusetts General Hospital
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Hasegawa, Kohei; Brenner, Barry E; Clark, Sunday et al. (2014) Emergency department visits for acute asthma by adults who ran out of their inhaled medications. Allergy Asthma Proc 35:42-50
Sills, Marion R; Ginde, Adit A; Clark, Sunday et al. (2010) Multicenter study of chronic asthma severity among emergency department patients with acute asthma. J Asthma 47:920-8
Rowe, Brian H; Camargo Jr, Carlos A; Multicenter Airway Research Collaboration (MARC) Investigators (2006) The use of magnesium sulfate in acute asthma: rapid uptake of evidence in North American emergency departments. J Allergy Clin Immunol 117:53-8
Schatz, Michael; Clark, Sunday; Emond, Jennifer A et al. (2004) Sex differences among children 2-13 years of age presenting at the emergency department with acute asthma. Pediatr Pulmonol 37:523-9
Cydulka, Rita K; Rowe, Brian H; Clark, Sunday et al. (2003) Emergency department management of acute exacerbations of chronic obstructive pulmonary disease in the elderly: the Multicenter Airway Research Collaboration. J Am Geriatr Soc 51:908-16
Boudreaux, Edwin D; Emond, Stephen D; Clark, Sunday et al. (2003) Race/ethnicity and asthma among children presenting to the emergency department: differences in disease severity and management. Pediatrics 111:e615-21
Silverman, Robert A; Boudreaux, Edwin D; Woodruff, Prescott G et al. (2003) Cigarette smoking among asthmatic adults presenting to 64 emergency departments. Chest 123:1472-9
Thomson, Carey Conley; Clark, Sunday; Camargo Jr, Carlos A et al. (2003) Body mass index and asthma severity among adults presenting to the emergency department. Chest 124:795-802
Keahey, Laine; Bulloch, Blake; Becker, Allan B et al. (2002) Initial oxygen saturation as a predictor of admission in children presenting to the emergency department with acute asthma. Ann Emerg Med 40:300-7
Pollack Jr, Charles V; Pollack, Emily S; Baren, Jill M et al. (2002) A prospective multicenter study of patient factors associated with hospital admission from the emergency department among children with acute asthma. Arch Pediatr Adolesc Med 156:934-40

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