included in the networks allows researchers to carry out trials designed to evaluate rare conditions or complications.

There are a number of primary care research networks in existence. For example, the AAP established the Pediatric Research in Office Settings (PROS) Network in 1986. The mission of this network is to improve the health of children and enhance primary care practice by conducting national collaborative practice-based research. In 2004, the network included more than 1,900 practitioners from over 700 offices in the 50 states, Canada, and Puerto Rico. The network is currently working on a variety of projects, including studies on how practitioners diagnose child abuse in primary care settings, on a new way to help parents prevent child violence, and on how to improve practice/clinic immunization rates. The Vermont Oxford Network (VON), founded in 1988, includes more than 485 neonatal intensive care units in the United States and other countries. It maintains a database that provides unique, reliable, and confidential data to participating units for use in quality management, process improvement, internal audit, and peer review. The network disseminates the results of its research in medical journals and through a network publication. The National Cancer Institute at NIH also has a pediatric research network—the Children’s Oncology Group (COG)—which was established in 2000. COG is a clinical trials cooperative group devoted exclusively to childhood and adolescent cancer research. It develops and coordinates clinical cancer trials conducted at its 238 member institutions in the United States, Canada, Europe, and Australia. COG members include more than 5,000 cancer researchers.

There are also several research networks focused on general aspects of emergency medicine. For example, Emergency ID Net is a CDC-funded, interdisciplinary, multicenter, ED-based network for research on emerging infectious diseases, established in cooperation with CDC’s National Center for Infectious Diseases. The network is based at 11 university-affiliated urban hospital EDs with a combined annual patient visit census of more than 900,000 (Talan et al., 1998). The Emergency Medicine Network’s Multi-Center Airway Research Collaborative (MARC) performs long-term research on airway disorders, including asthma, chronic obstructive pulmonary disease, anaphylaxis, pneumonia, and bronchiolitis. Many of the studies investigate both adults and children. The Emergency Medicine Cardiac Research and Education Group International, an industry-sponsored group centered in Cincinnati, Ohio, was established in 1989 to conduct multicenter clinical trials on serum markers for the early diagnosis of acute myocardial infarction. Since its inception, the network has grown from 18 researchers in 15 institutions to 44 researchers in 31 academic facilities worldwide. These collaboratives have a well-defined group leadership, such as a steering committee or board of directors; have produced multiple publications; and in many cases have received funding support from di-

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