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Background:
In the
summer of 1959, the U.S. Senate Committee on Appropriations recognized
the need to expand federal support of clinical studies in health and
human disease. The committee recommended that special centers for
clinical research be established throughout the country to address the
deficit in clinical investigation.
Two years later, a nationwide clinical research program was developed
by the National Institutes of Health (NIH). Funds were released in May
1960 for the establishment of "General Clinical Research Centers."
Three months following the announcement, nineteen medical schools
responded with requests to form centers.
The University of Virginia General Clinical Research Center (GCRC)
opened in April 1968. It is an NIH-supported multi-disciplinary
research facility located on the 8th Floor of the University Hospital
of the University of Virginia Health System. The GCRC provides
investigators with the specialized resources necessary to conduct
advanced clinical research. The facility includes inpatient beds,
skilled research nurses, a core assay laboratory, a metabolic kitchen,
outpatient facilities, computing and statistical consultants and
facilities, and sleep and exercise physiology
laboratories.
What type of
studies are done here?
More than
250 research protocols have been, and are being, pursued on the
GCRC. Selected themes are illustrated
below:
- Regulation of growth hormone secretion in children, young adults, and
the elderly in health and disease.
- Hormonal changes in the menopause with or without estrogen
replacement.
- Anatomic and physiologic basis for, and consequences of, the sleep
apnea syndrome.
- Metabolic responses to exercise in obese subjects, athletes, and the
aged.
- Mechanisms of rennin, prorenin, and aldosterone
regulation.
- Relevance of air and body-borne allergies to asthmatic
disease.
- Therapeutic effects of anticonvulsant and antihypertensive
drugs.
- Impact of renal transplantation on pancreatic beta-cell
function.
- Impact of pancreatic transplantation in diabetes
mellitus.
- Effects of steroid hormones on pituitary function and body
composition.
- Pathophysiology of gastrointestinal motility disorders.
- Neuroendocrine physiology of puberty in boys and girls.
- Metabolic markers and consequences of diabetes mellitus.
Resources of
the GCRC:
Semi-private
inpatient beds
Outpatient facilities for clinical research studies
Protocol Development
Office
Metabolic Kitchen staffed by a bionutritionist
and bionutrition chefs trained in research
Experienced and Skilled Research
Nurses present 24 hrs/day
Core Laboratory facilities including the capability to develop new
research assays
Access to state-of-the art computing and
software programs custom-designed to store, protect and analyze
clinical research data
Computer and graphics consultants for basic and complex
projects
Statistical, Biomathematical
and study design consultation
Exercise Physiology
Laboratory
Sleep Research Laboratory
Research Subject Advocates
Access to all hospital services, including
radiology, electrocardiography, physical and occupational therapies,
chaplains, pharmacy and social work
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Institutional Review Board for Health Sciences
Research:
All clinical
research plans are submitted to thoughtful, complete, unhurried, and
committee-wide review by a panel of physicians, scientists, ethics,
religious and community representatives. The Institutional Review
Board for Health Sciences Research must grant prior approval
before any clinical research study is initiated. All studies are
voluntary, and carried out only after written informed consent is
provided by the volunteer. A subject may decline initial or
continuing participation in any study for any reason at any
time.
The GCRC Research Advisory
Committee:
All clinical
experiments must also be reviewed and approved for scientific merit,
validity, significance, relevance, and feasibility by the GCRC Research
Advisory Committee. This advisory board is chaired by the Dean of the
Medical School. Voting members are MD and PhD scientists with diverse
research experience and statistical expertise to offer critical advice
and constructive guidance.
Training of Physicians and
Scientists:
An integral
activity of the GCRC is the stimulation, direction, training, and
preparation of physicians and scientists at various stages of their
careers for significant clinical research accomplishments. Training is
by mentorship, formal coursework, weekly clinical rounds, and an annual
clinical research day with external scholars in attendance. These
avenues offer a significant impetus to physicians at multiple stages in
their clinical research training, beginning in medical school and
extending through internship, specialty residency training,
post-doctoral subspecialty fellowship, and academic faculty-level
investigator-ship.
The Multidisciplinary Training Program in
Clinical Investigation or MTPCI was created to foster the
development of physicians and scientists into successful, independent
clinical investigators. The program is supported by
the School of Medicine and the
General Clinical Research Center
Who pays for the services?
Most costs
are borne by our NIH GCRC grant. For example, room charges, nursing
care, basic laboratory studies, meals, and the cost of computer usage
are paid by the GCRC grant. Investigators with clinical study protocols
approved by the Institutional Review Board for Health Sciences
Research and supported by peer-reviewed intra- or extramural funds
receive these services at no cost. If an investigator is carrying out
an industry-initiated study, fees are charged based on proportionate
utilization of resources.
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