Would you like to join COSBID ?
November 2007:
Collection of the pilot dataset is now progressing well and we have enrolled some 60 patients. Incidence of spreading depression (depolarisation) events (as % of patients affected) is currently approximately 50% in both trauma (focal contusion or haematoma) and also now in subarachnoid haemorrhage.
When 6-month follow-up is available on approximately 100 patients, we expect to carry out a power analysis and design a definitive test of the core (null) hypothesis - that occurrence of depolarisation events has no impact on outcome.
This is likely to require a considerable number of patients and we expect to seek help in recruitment and data collection from many clinical neuroscience centres world wide who have experience in the monitoring of patients with acute cerebral trauma and/or ischaemia, and, not least, after surgery for aneurysmal subarachnoid haemorrhage (this last group would be especially informative in centres where early surgical treatment for patients in middle-low grades is practised).
It is possible as this work progresses that new avenues for therapy will suggest themselves, and for this reason we firmly believe that it is vital to obtain an answer to the core question before any therapeutic studies are considered. This will require recruitment of the study group as quickly as possible, and ideally within a period of perhaps 2-3 years.
We therefore invite you now to tell us whether you might be interested in joining COSBID as an accredited member (see below), to adopt the monitoring procedures and contribute data. This is essentially a question and invitation for neurosurgeons and perhaps neuro-intensivists, and we ask you to send any expressions of possible interest by email to:
Prof. Anthony Strong (Department of Neurosurgery at King’s College Hospital, London SE5 9RS) (Anthony.strong@kcl.ac.uk).
The participants in the current pilot have met now on 3 occasions, and have all become very enthusiastic about the project.
A final study design is unlikely to be available for discussion until well into 2006, and our aim will be to arrange a meeting to discuss this, in conjunction with a relevant international meeting likely to be attended by a large number of potential participants in COSBID.
The Coordinators (see below) look forward to hearing from you.
General contacts
email to Dr Martin Fabricius: MARFAB01@glostruphosp.kbhamt.dk
Coordinators
| Jens Dreier | Charite, Berlin, Germany | jens.dreier@charite.de |
| Martin Fabricius | Glostrup Hosp. & Univ. Copenhagen, Denmark | MARFAB01@glostruphosp.kbhamt.dk |
| Rudolf Graf | Max-Planck Institut, Cologne, Germany | rudolf.graf@nf.mpg.de |
| Jed Hartings | Walter Reed Army Institute of Research, Silver Spring, MD, USA | Jed.Hartings@NA.AMEDD.ARMY.MIL |
| Martin Lauritzen | Glostrup Hosp. & Univ. Copenhagen, Denmark | marl@glostruphosp.kbhamt.dk |
| Anthony Strong | Kings College Hospital, King's College London, UK | anthony.strong@kcl.ac.uk |
Experimental section
At the June 2005 meeting in Cologne, it was agreed to form an Experimental Section, which will comprise research-active basic neuroscientists studying mechanisms with a bearing on spreading depression, who can provide experience and advice that will inform the main clinical research activities of COSBID. It is expected that investigators joining this section will be willing, like the accredited members, (1) to contribute actively to grant-writing, and (2) to recruit neuro-clinicians in their centre to contribute core clinical data to COSBID.
Only accredited members of COSBID- currently defined as centers participating in the first phase of the patient study - receive access to additional features (newsletters, downloads, address book, discussion forum, software tools, notice of meetings). Other centers interested in joining COSBID should register. These centers will be invited to participate in the second phase of the study (currently projected to starting in summer 2006). As they become accredited members of COSBID, they will receive access to additional features.
Groups and individuals sharing common interest in the investigation of depolarisations in the injured brain but not intending to participate in the patient study are also welcome to register as associate members. They will receive notice of progress reports presented for example in this homepage, and of meetings open to the scientific community.
Pre-requisites for joining COSBID as a center to participate in the second phase of the patient study (accredited member):
completion of the registration form
Pre-requisites for joining COSBID as a research group/individual (associate member):
completion of the registration form