DESCRIPTION (provided by applicant): Acute neurologic disorders, relative to their effect on society, have been very poorly studied. Many of these neurological problems require emergent evaluation and treatment, ideally by a multi-disciplinary team. The NETT network has been established to address just these issues as the discovery and implementation of effective treatments for neurological emergencies will require sophisticated study protocols derived from large-scale clinical trials. The success of this initiative hinges not only on a well-coordinated central data management center, but also on hub and spoke sites that have the competence to enroll patients emergently across a large demographic. The broad and long-term goal of this program is to test and institute new effective therapies for neurological emergencies and improve the overall health of Americans. The project design is that of a central coordinating "Hub" (Dept. of Emergency Medicine, Wayne State University - WSU) which has proven expertise in emergency patient care and emergency based clinical trails. The "Spokes" (Detroit Medical Center and William Beaumont Hospitals) offers: i) expertise in the neurosciences from the bench to the bedside, 2) proven competency in enrolling patients into emergent interventional trials, 3) over 500,000 emergency department visits across a wide demographic that blankets Southeast Michigan and 4) a long history of inter-hospital, interdepartmental and interdisciplinary collaboration. Dr Robert Welch, in conjunction with Dr. Brian O'Neil, has an enviable group of established collaborators that include both adult and pediatric emergency medicine physicians, neurologists, neurosurgeons, critical care specialists and trauma surgeons. The WSU "Hub" has a breadth of experience in emergent intervention trials initiated pre-hospital and continued throughout the emergency department, hospital and rehabilitation phases. WSU investigators have successfully enrolled patient in the pre-hospital interventional trials Res-Q, PAD, PolyHeme, DCAR, POST and Cerebral oximetry trials. Furthermore the same investigators have been leaders in enrolled patients in various emergent interventional trials such as RESCUE, TIA-ADP, PECARN, ONO-REACT, BADHIT, Gen-IMS, PROACTION, and RESCUE-ACS. In each of these trials our sites have exceeded expectations and provided high volume and high quality clean data to the principal investigators. A number of these studies required community consultation for implementation. The WSU site is equipped with an integrated and sophisticated electronic medical record system that links hospital sites. The system has advanced telemedicine capabilities, which further augments patient evaluations and consultation. The NETT Network will perform research studies that will ultimately result in new and effective treatment s of neurological emergencies. These new treatments will be disseminated to practicing doctors and their patients and will improve the health and lives of the public.

Acute neurological emergencies often have lasting debilitating effects on patients not only in the United States, but all over the world. This project is relevant to overall public health because the discovery of new therapies can result in even small degrees of improvement that can impact important and lasting changes in patient function and quality of life.