title: A strategic plan to accelerate development of acute stroke treatments.
abstract: In order to reenergize acute stroke research and accelerate the development of new treatments, we need to transform the usual design and conduct of clinical trials to test for small but significant improvements in effectiveness, and treat patients as soon as possible after stroke onset when treatment effects are most detectable. This requires trials that include thousands of acute stroke patients. A plan to make these trials possible is proposed. There are four components: (1) free access to the electronic medical record; (2) a large stroke emergency network and clinical trial coordinating center connected in real time to hundreds of emergency departments; (3) a clinical trial technology development center; and (4) strategic leadership to raise funds, motivate clinicians to participate, and interact with politicians, insurers, legislators, and other national and international organizations working to advance the quality of stroke care.
authors.affiliation: National Institute of Neurological Disorders and Stroke Acute Stroke Study Group, National Institutes of Health, Rockville, Maryland, USA. johnmarler@verizon.net
authors.forename: John R
authors.initials: JR
authors.lastname: Marler
mesh_terms: D000208:Acute Disease; D035843:Biomedical Research / Q000458:organization & administration*; D002986:Clinical Trials as Topic / Q000191:economics / Q000379:methods*; D057286:Electronic Health Records; D004636:Emergency Service, Hospital / Q000458:organization & administration; D006747:Hospital Communication Systems; D006801:Humans; D007857:Leadership; D009042:Motivation; D015337:Multicenter Studies as Topic / Q000191:economics; D018579:Patient Selection; D012106:Research; D012108:Research Personnel; D012109:Research Support as Topic; D020521:Stroke / Q000628:therapy*