Research

Research is a core mission at the University of Cincinnati Department of Emergency Medicine. Our commitment to excellence in research enhances our reputation as one of the premier academic emergency medicine departments in the United States.

The Research Division is supported by an array of federal grants, industry studies, and public health funding, with an extensive history of research across the full translational spectrum, from basic science to clinical trials to implementation science and health systems research. The Research Division encompasses an integrated team of passionate investigators, lead coordinators/project managers, grant and account managers, operations and contract managers, data managers, and regulatory experts. Our researchers are active throughout the hospital with special access to the Neuroscience Intensive Care Unit and the Medical Intensive Care Unit. The division facilitates all research conducted within the department from small projects of individual interest to large scale clinical trials. Every member of the department is actively supported and encouraged in their research endeavors by their peers, mentors, and the Research Division. We support researchers as they pursue funding for original investigations through National Institutes of Health (NIH) mechanisms and have faculty receiving K, T, R and U awards. We also prioritize public health research through federal, state, county, and local grant sources. Our industry-sponsored portfolio is wide ranging and supports much of our participant recruitment activities. Research in emergency medicine (EM) often overlaps with other specialties creating strong collaborations with our hospital-based colleagues in neurology, cardiology, trauma, and surgery, as well as with outpatient services and health policy and systems specialists. It is also frequently the case that patients enrolled in research studies are under the clinical care of a non-research focused attending or resident.

It is for this reason that our department has made it our policy that every physician in the EM department is trained in human subject’s protection. Above all, we are passionate about our research and proud of our achievements; through our research we can improve patient care. We recognize that the mission of discovery through research is the principal activity that distinguishes our academic health center from other health systems in the region.

Our division has an extensive history of research with clinical laboratory requirements, including biomarker discovery and testing, drug evaluation, and biological specimen banking/repository. Clinical laboratory services are provided through the department’s Biological Specimens Banking Center. There are two clinical research laboratories maintained at our university base location: a 165 square foot area located within the Emergency Department at the University of Cincinnati Medical Center (UCMC), equipped with a refrigerator/freezer for specimen and reagent storage, a centrifuge for sample processing and bench space for point-of-care testing instruments. In the Medical Sciences Building we have a 580 square foot laboratory which contains bench space for instrumentation, a centrifuge for sample processing and six -80°/-85° C freezers for specimen banking.

The Participant Recruitment and Clinical Research Service Center is a unique resource provided by the Research Division to support research conducted across the College of Medicine (COM) and beyond. The service center team provides a centralized, coordinated approach to screening and recruiting both the ED and inpatient population for research participation 24-hours a day, 365-days a year through the use of the Electronic Medical Health Record (EMR/EHR) and the High Enroll handheld platform, to maximize subject identification. Collaboration with other departments implementing the acute timelines required for research such as subject enrollment, biological specimen processing and banking, and phlebotomy for carefully timed research samples is what makes this program a strong asset to not only our division but to the multiple acute care departments/divisions within the university and throughout the hospital system. Central to our activities is screening patients for research. The service center team screens an average of 130,000 patients per year for possible participation in research studies and enrolls an average of 350 patients. Over the last five years the service center has worked in collaboration with ten COM departments enrolling 49 studies from these outside departments.

Over the last five years, EM research faculty have been involved in the following national and local collaborative programs/grants: Strategies to Innovate EmeRgENcy Care Clinical Trials Network (SIREN), NIH/NINDS Network of Excellence in Neuroscience Clinical Trials (NeuroNEXT/CincyNEXT), NIH/NINDS Stroke Network (StrokeNET), and the Center for Clinical and Translational Science and Training Acute Care Core (ACRC).  Our abundance of input to national and international conferences and research forums, and the plethora of publications authored by our faculty, fellows, and residents, attest to our commitment to research and to our wealth of experience.

The EM Research Division has also partnered with both ground and air Emergency Medical Services, collaborating with Cincinnati Fire Department on a therapeutic randomized controlled trial and several epidemiological studies.

The Research Division, led by our Vice Chair of Research and Director of Research, develops annual reports for review by the Chair of the Department and COM Dean. These reports include the spectrum of funded investigations across sources from NIH, Department of Defense, industry-sponsored clinical trials, and state, local, and county funded harm reduction and health policy work.

Recent Initiatives

Initiatives to foster current and future research within the research division include EM Research Scholarship and Innovation Meeting (EM-RSI), resident research initiatives, research fellowship, and neurovascular/neurocritical care fellowship.

EM-RSI is a standing bi-monthly meeting integral to our research process. It is the mechanism through which all research projects involving EM investigators must pass before they are submitted to the Institutional Review Board (IRB), to the Institutional Animal Care and Use Committee, or to internal or external funding agencies.  More than just approving research, EM-RSI is a workshop for fine-tuning research protocols, vetting ideas and funding strategies, and fostering collaboration. This meeting is open to all faculty, residents, and staff.

An effort to grow the research pipeline is evidenced through our residency research initiatives with the goal to maximize residents’ exposure to research and increase the number of residents taking on projects to publication. Residents have the opportunity to participate in education on research topics through formal Grand Rounds presentations and discussions at journal clubs. Research faculty host a quarterly Journal Club where three high impact research articles are reviewed by residents with a quick hit research methodology lecture. The research elective is a two-week dedicated block, but also an ongoing longitudinal experience. Residents are guided along the entirety of a research project, from formation of a PICO (population, intervention, control and outcomes) question, literature search, IRB submission, methods planning, execution of the project and publication. The Resident Research Director provides oversight to ensure that content, research, and biostatistical expertise are all represented within the mentorship team for each project. Resident research may be funded through the resident research grant, up to $2,500. This program is supported by donations from current faculty and alumni. Residents submit a competitive grant application, modeled on the traditional NIH proposal, which is then peer-reviewed by research faculty. Residents choosing the research track are mentored through a stepwise program of training and experiential activities resulting in them leaving residency with extensive research training, multiple publications in the peer-reviewed literature, and a competitive advantage as they explore post-residency academic life. Any resident choosing to pursue an independent program of research is expected to prepare a formal protocol, obtain funding if appropriate, and lead the project and preparation of presentations/manuscripts.

The research fellowship is one of only 18 in the country accredited by the Society of Academic Emergency Medicine. A core expectation for fellows is completing a research-based master’s degree in clinical and translational science, epidemiology, or public health. They are also required to submit an application for a career development award (or independent research grant), publish a minimum of two manuscripts, and participate in various educational ventures.

The neurovascular/neurocritical care fellowship provides the EM residency graduate with training in acute neurovascular emergencies. The training is accomplished in collaboration with the Greater Cincinnati/Northern Kentucky Stroke Team through clinical experience involving acute stroke intervention, as well as through didactic education in research methodology, biostatistics, and principles of research design. The fellow also takes primary stroke call, which includes enrolling patients in clinical trials. The Department of Neurology and the Division of Neuroradiology provide training in neuro-imaging, including computed tomography, magnetic resonance imaging, magnetic resonance angiography and transcranial doppler. An additional year of training in neurocritical care is required, during which fellows learn how to manage critically ill patients with primary neurologic disorders. In addition to managing neurosurgical and neurologic emergencies, they also learn skills of EEG reading, bronchoscopy, invasive hemodynamic management, and ventilator management. The fellowship is funded by the NIH (T32, Dr. Woo).