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Clinical Research Network: JHCRN Infrastructure and Lessons Learned.
No full textClinical research studies are becoming increasingly complex resulting in compounded work burden and longer study cycle times, each fueling runaway costs. The impact of protocol complexity often results in inadequate recruitment and insufficient sample sizes, which challenges validity and generalizability. Understanding the need to provide an alternative model to engage researchers and sponsors and bringing clinical research opportunities to the broader community, clinical research networks (CRN) have been proposed and initiated in the United States and other parts of the world. We report on the Johns Hopkins Clinical Research Network (JHCRN), established in 2009 as a multi-disease research collaboration between the academic medical centers and community hospitals/health systems. We have discussed vision, governance, infrastructure, participating hospitals\u27 characteristics, and lessons learned in creating this partnership. Designed to leverage organized patient communities, community-based investigators, and academic researchers, the JHCRN provides expedited research across nine health systems in the mid-Atlantic region. With one IRB of record, a centralized contracting office, and a pool of dedicated network coordinators, it facilitates research partnerships to expand research collaborations among the differing sizes and types of hospitals/health systems in a region. As of August 2024, total 81 studies-clinical trials, cohort studies, and comparative effectiveness research have been conducted, with funding from the NIH, private foundations, and industry. The JHCRN experience has enhanced understanding of the complexity of participating sites and associated ambulatory practices. In conclusion, the CRN, as an academic-community partnership, provides an infrastructure for multiple disease studies, shared risk, and increased investigator and volunteer engagement
Factors Associated With Rehabilitation Length of Stay in Patients With Traumatic Brain Injury: A Retrospective Cohort Study.
No full textThis retrospective cohort study aimed to identify predictive factors for patients with traumatic brain injury (TBI) requiring short (≤ 14 days) or long (≥ 15 days) rehabilitation length of stays (LOSs).The study was conducted in an acute rehabilitation hospital associated with a community-based tertiary medical center. Patients who were admitted to the acute inpatient rehabilitation unit with TBI between January 2020 and September 2022 were included (n = 197). The mean rehabilitation LOS of the 197 patients was 16.73 ± 9.4 days. A long rehabilitation LOS was associated with a higher rate of urinary tract infection in the rehabilitation facility (p = 0.002), a higher rate of lung infection in the inpatient rehabilitation facility (p = 0.003), unplanned readmission to acute care (p \u3c 0.001), a longer LOS in acute care before admission to rehabilitation (p \u3c 0.001), and a lower Section GG score on admission to rehabilitation (p \u3c 0.001). The logistic regression model revealed having lower Section GG scores on admission to rehabilitation as the only factor predictive of a long rehabilitation LOS (odds ratio, 0.91; p \u3c 0.001). Our study revealed that the Section GG score at admission to inpatient rehabilitation facilities is a predictor of rehabilitation LOS
Preoperative risk assessment tools and their relationship, or lack of, to social determinants of health in orthopedic patients: A scoping review
No full textInvestigating treatment interventions among patients with opioid use disorder in a trauma setting
No full textGranulomatous Polymyositis and Hypercalcemia: Atypical Manifestations of Chronic Graft-versus-Host Disease
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Increasing Carbohydrate Intake to Reduce Cholesterol Levels: A Lean Mass Hyper-Responder
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