Raffaele Ornello, MD
Broderick JP, Elm JJ, Janis LS, Zhao W, Moy CS, Dillon CR, Chimowitz MI, Sacco RL, Cramer SC, Wolf SL, et al. National Institutes of Health StrokeNet During the Time of COVID-19 and Beyond. Stroke. 2020.
The National Institutes of Health StrokeNet is a wide collaborative network promoting trials in the field of stroke. The project was established in 2013, and, to date, it involves about 500 centers throughout the United States. Over the years, StrokeNet has given a substantial contribution to stroke research, not only favoring the completion of previously funded trials such as the POINT and SHINE trials, but also autonomously funding trials such as DEFUSE 3, ARCADIA, and Telerehab. StrokeNet also has educational goals and a special interest in homogenizing stroke imaging across sites.
The recent COVID-19 pandemic represented a challenge for stroke research, as it caused the forced suspension of all ongoing trials at the end of March and imposed rapid changes in protocols and operating procedures due to logistic barriers and safety concerns. In this context, StrokeNet showed a great capability of analyzing the new and unprecedented situation and providing rapid adaptations of the ongoing protocols. Those adaptations include a substantial use of telemedicine and remote solutions, the use of online surveys, an increasing use of innovative designs such as exemption from informed consent (EFIC), and reconsideration of processes such as timing of enrollment and outcome assessment. StrokeNet promptly responded to the COVID-19 pandemic, providing guidance to the principal investigators of ongoing trials, in which they were invited to adhere to safety recommendations and encouraged to use telemedicine, and modifying some aspects of data collection and patient follow-up due to the pandemic emergency.
COVID-19 was a ‘stress test’ for StrokeNet. Such a large network was useful not only to generate new ideas, but also to respond quickly to rapidly changing scenarios such as a virus outbreak. A wide network involving a large number of young researchers is not only a good role model to design stroke research, but also a good platform to rapidly adapt to potentially disrupting challenges. The results of StrokeNet encourage the creation of wide collaborative networks of research, not only in the field of stroke.