title: The future of cardiovascular clinical research in North America and beyond-addressing challenges and leveraging opportunities through unique academic and grassroots collaborations.
abstract: Recent developments have highlighted the challenges facing cardiovascular clinical research in global contemporary practice, particularly in North America, including shifting priorities for drug development targets, increasing regulatory requirements, and expensive operational approaches for conducting randomized clinical trials. Nonetheless, emerging trends such as the consolidation of practices and hospitals into integrated health systems, the integration of electronic health records from thousands of practices into large data repositories to support prospective research studies, and streamlined operational approaches such as registry-based trials and risk-based monitoring have created numerous opportunities to disrupt the clinical research paradigm. Within this context, academic research organizations around the globe, particularly a strengthened collaboration of 3 established academic research organizations in North America, are uniquely positioned to promote and develop grassroots collaborations across all types of clinical practices, to delineate successful solutions to obstacles that limit clinical research initiatives, and to guide the future of cardiovascular research in the global research environment.
authors.affiliation: Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC. Electronic address: matthew.roe@duke.edu.
authors.forename: Matthew T
authors.initials: MT
authors.lastname: Roe
authors.affiliation: Department of Medicine, Stanford University School of Medicine, Stanford, CA.
authors.forename: Kenneth W
authors.initials: KW
authors.lastname: Mahaffey
authors.affiliation: Canadian VIGOUR Centre, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Justin A
authors.initials: JA
authors.lastname: Ezekowitz
authors.affiliation: Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC.
authors.forename: John H
authors.initials: JH
authors.lastname: Alexander
authors.affiliation: Canadian VIGOUR Centre, University of Alberta, Edmonton, Alberta, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Shaun G
authors.initials: SG
authors.lastname: Goodman
authors.affiliation: Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC.
authors.forename: Adrian
authors.initials: A
authors.lastname: Hernandez
authors.affiliation: Canadian VIGOUR Centre, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Tracy
authors.initials: T
authors.lastname: Temple
authors.affiliation: Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC.
authors.forename: Lisa
authors.initials: L
authors.lastname: Berdan
authors.affiliation: Duke Translational Medicine Institute, Duke University School of Medicine, Durham, NC.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Califf
authors.affiliation: Department of Medicine, Stanford University School of Medicine, Stanford, CA.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Harrington
authors.affiliation: Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC.
authors.forename: Eric D
authors.initials: ED
authors.lastname: Peterson
authors.affiliation: Canadian VIGOUR Centre, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Paul W
authors.initials: PW
authors.lastname: Armstrong
mesh_terms: D000046:Academic Medical Centers / Q000639:trends*; D035843:Biomedical Research / Q000639:trends*; D002309:Cardiology / Q000639:trends*; D002986:Clinical Trials as Topic / Q000639:trends; D003299:Cooperative Behavior; D005544:Forecasting; D006801:Humans; D007400:Interprofessional Relations; D009656:North America; D012109:Research Support as Topic / Q000639:trends