In May 2009, emergency physicians from seven Clinical and Translational Science Award (CTSA) institutions met at the annual meeting of the Society for Academic Emergency Medicine (SAEM) to discuss ideas for collaborative emergency care research projects that could build upon the CTSA framework.

This meeting followed several similar meetings that had taken place at the SAEM annual meetings in the previous 3 years about brainstorming ideas for integrating emergency care research and emergency medicine into CTSAs in a collaborative fashion.

As an initial project, the group decided to pursue a multisite, community-based translational research project assessing the accuracy, redevelopment, and cost-effectiveness of out-of-hospital trauma triage guidelines.

This project was already supported by a grant from the Robert Wood Johnson Foundation (RWJF) Physician Faculty Scholars Program, and it originally included two CTSA sites. The project was expanded to seven sites, with the RWJF grant providing partial support for the additional sites. This support was matched by CTSA grants at five sites.

As part of this initial pilot effort, the group formalized the first inter-CTSA network dedicated exclusively to emergency care research: the Western Emergency Services Translational Research Network (WESTRN). The seven sites are Oregon Health & Science University (OHSU), Harborview/University of Washington, University of California at Davis, San Francisco General Hospital/UC San Francisco, Stanford University, Denver Health/ University of Colorado, and University of Utah. Collaborators are interdisciplinary, representing emergency medicine, pediatric emergency medicine, emergency medical services, and trauma surgery.

Since its inception, WESTRN has collected data for more than 325,000 injured patients at the seven sites in a detailed assessment of regionalized trauma care (principal investigator: Craig D. Newgard, OHSU). To date, this project has resulted in five abstracts, with multiple manuscripts in development.

An additional CTSA grant has been obtained from the UC Davis CTSA to support another multicenter WESTRN project evaluating the variability in intensive care and resource utilization among patients with traumatic brain injuries (principal investigator: Daniel Nishijima, UC Davis).

The network has also obtained an R01 from the Centers for Disease Control and Prevention to study field triage at two WESTRN sites (principal investigator: Craig D. Newgard, OHSU). Another R01 application is in review by the National Institutes of Health (NIH) as part of an Emergency Medical Services for Children (EMS-C) grant to validate decision rules for CT use in children with head or abdominal trauma (seven WESTRN sites; principal investigators: James Holmes and Nathan Kuppermann, UC Davis).

Further, the network has two research fellowship training grants in review by the NIH and the Emergency Medicine Foundation to conduct a prospective validation study of an instrument to predict multiple organ failure in trauma patients (three WESTRN sites; principal investigator: Jody Vogel, mentor: Jason Haukoos, Denver Health).

Finally, the network is gathering pilot data to support another federal grant to study the effects of methamphetamine use on congestive heart failure (principal investigator: Deborah B. Diercks, UC Davis).

WESTRN serves as a flexible confederation of sites for studying multiple potential content domains within emergency care. The flexible configuration of the network allows for different sites to serve as the data coordinating center, depending on the study. Current projects include work in the health services, trauma care, EMS, pediatric injury care, and toxicology fields.

To date, the network has focused on community-based translational research and collaborations for emergency care research both within and between CTSA institutions. We are seeking further collaboration with each of our CTSAs to continue introducing emergency research to CTSA leaders, to better facilitate collaboration, and to utilize CTSA resources and infrastructure in a way that promotes the science of emergency care, while also benefiting CTSAs.

We hope these efforts demonstrate the energy, grassroots organization, motivation, and determination of emergency care investigators, as well as the many synergistic translational research opportunities between emergency care, CTSAs, the NIH, and other federal funders.

Dr. Newgard is an associate professor in the Department of Emergency Medicine and is director of the Center for Policy and Research in Emergency Medicine at Oregon Health & Science University, Portland.