Acutelines
Acutelines Hospital-based biobank to facilitate acute care and emergency research. Facility
Hospital-based biobank to facilitate acute care and emergency research.
Research in acute care faces many challenges, such as enrolment challenges, legal restrictions on data sharing, lack of single ‘ownership’ of the domain of acute care, and the absence of integrated data about the patient journey in acute care, from the onset of the acute disease to well after hospital discharge. To overcome these challenges, we have established a de novo biobank for acute and emergency medicine: Acutelines.

The aim of this biobank is to improve the recognition and treatment of acute diseases and to gain insight into the consequences of acute diseases, including factors that predict their outcome. In addition, Acutelines contributes to the development of acute personalized treatment and helps to better predict patient outcomes after acute admission.

Our aims include:

  • Facilitating research in acute and emergency medicine, by providing the framework for novel clinical studies;
  • Facilitating translational research in order to develop acute personalized medicine, by providing data, images, and biomaterials;
  • Monitoring and improving quality of care in acute and emergency medicine.

We prospectively include adult patients (aged ≥ 18 years) visiting the emergency department who are being referred to healthcare professionals from internal medicine, nephrology, geriatric medicine, oncology, haematology, pulmonology, rheumatology, gastroenterology and hepatology, or emergency medicine (non-trauma). The emergency nurse and a trained research assistant screen all patients’ eligibility for inclusion in Acutelines and collection of their data and biomaterials.

Data and biomaterial collection during acute, hectic moments

Samples will be collected prior to the start of treatment, as soon as possible after presentation. A deferred proxy consent procedure is in place to allow the collection of data and biomaterials before having obtained written consent. Clinical data, imaging data and biomaterials (blood, urine, faeces, and hair) will be collected. The digital infrastructure used ensures the automated capturing of all bedside monitoring data (vital parameters and electrophysiological waveforms), and the secure import of data from other sources, such as the electronic health records drawn up by the hospital staff, ambulance staff, general practitioner, the municipal registration, and the pharmacy.

  • In order to allow any biomaterial collection to take place as soon as possible, the patients’ eligibility for inclusion will be screened by the emergency nurse and a trained research assistant upon arrival at the emergency department. After potentially eligible participants have been identified and informed, the nurse will perform a regular venepuncture and also collect blood specimens for Acutelines. Subsequently, the research assistant will give information to the participants and their relatives, obtain proxy consent, and collect and process data and biomaterials at the emergency department. Additionally, information about prehospital care will be obtained from the Helicopter Emergency Medical Service (HEMS).

  • Data will be collected from all the included participants during the first 72 hours of their hospitalization and follow-up data will be collected 3months, 1 year, 2 years, and 5 years after their visit to the emergency department. We will ask the participants to complete questionnaires in order to obtain information about their symptoms, quality of life, functioning, and outcome goal prioritization. Additionally, we will obtain data about medication use, comorbidity, and mortality from the electronic health records at our hospital and from external sources (i.e. the general practitioner, pharmacy, health care registration, central statistics office, and municipal registration).

  • The collected data and biomaterials can be made available to other researchers upon request by submitting the completed research protocol. Each request for further use of the data and/or biomaterials will be evaluated by Acutelines and the UMCG’s Central Reviewing Committee (CRc).

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Background information

  • The Acutelines infrastructure allows screening of all patients admitted to the emergency department. Here are facilities to rapidly process biomaterials. Our IT infrastructure enables us to obtain (high-frequency) cardiorespiratory signals and to transfer data from the electronic health records to the research database.
    The Acutelines infrastructure allows the assessment of the effects of novel techniques (such as algorithms and devices) on diagnosis, treatment, monitoring, outcome, and logistics in the emergency department, as well as a rapid implementation of these techniques in clinical practice. Acutelines is integrated in a large academic hospital, which ensures structured data storage and management and continued adherence to high legal and ethical standards.

    Access to central registries via trusted third parties allows us to obtain prehospital and longterm follow-up data from external sources (i.e. the general practitioner, pharmacy, healthcare registration, central statistics office, and municipal registration). Acutelines adheres to the following laws and guidelines:

    • Good Clinical Practice (GCP);
    • Good Laboratory Practice (GLP);
    • General Data Protection Regulation (EU) (2016/679);
    • ISO 9001:2008.

    Acutelines is registered under trial registration number NCT04615065 at ClinicalTrials.gov.

  • According to the most recent version of the Acutelines protocol, participants have to meet at least one of the following criteria in order to be eligible for inclusion:

    • Patients in the highest and second-highest urgency triage categories (red, orange) of the Emergency Severity Index (ESI);
    • Patients in the third-highest urgency triage category (yellow) of the ESI when arriving by HEMS transport;
    • Patients with several specific conditions, regardless of the urgency triage category that they are in: early sepsis, shock, syncope, anaphylaxis, acute renal failure, electrolyte disturbances intoxications, COPD and asthma exacerbations, actual or suspected deep vein thrombosis or pulmonary embolism, gastrointestinal bleeding, and bleeding from any source while using vitamin K antagonists or DOACs.

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  • Clinical data

    • Reason for admission, including signs and symptoms;
    • Physical examination and vital parameters (e.g. body temperature, blood pressure, heart rate, breathing frequency);
    • General characteristics (e.g. judgment of treating physician);
    • Additional results (e.g. X-ray images, scans, ultrasound scans, laboratory test results);
    • Pharmacologic and non-pharmacologic treatment.

    Questionnaires

    • Demographic data (e.g. age, sex, marital status, education, living situation, ethnicity);
    • Family history;
    • Lifestyle (e.g. smoking, alcohol consumption, illicit drug use);
    • Global functioning and experienced health (e.g. EQ-5D-5L, Katz-15 scale, Piper Fatigue Scale-12, PHQ-15);
    • Mood (e.g. PHQ-2, PHQ-9, GDS-15);
    • Shared decision-making (e.g. PSQ-18, OPT);
    • Nutrition and activity (e.g. SNAQ, MUST, SQUASH);
    • Frailty, delirium and cognitive functioning (e.g. VMS frail older patients, 4-AT, 6-CIT).

    Biomaterials

    • Serum;
    • Citrate plasma;
    • EDTA plasma + buffy coat (DNA);
    • Heparin plasma;
    • Whole blood (PAXgene RNA extraction);
    • Urine;
    • Faeces;
    • A lock of hair.
  • Top-notch researchers are necessary to make Acutelines successful. Therefore, we are continuously looking for smart, motivated people to support the team. Students from either universities of applied sciences or research universities who have a medical or biomedical background (such as medicine, technical medicine, pharmacy, nursing, biology, life sciences, biomedical sciences), a scientific or technical background (such as epidemiology, artificial intelligence, informatics or bioinformatics) are encouraged to contact us to participate in long or short research projects or to join our team as a research assistant for a longer period of time.

    From time to time, we also recruit students with other backgrounds, such as communication or management studies (i.e. facility and process management). In addition to facilitating research in the field of acute and emergency medicine, Acutelines organizes an educational programme of acute and emergency medicine for its team members.

  • Patient information: read more about Acutelines (in Dutch)

Contact

University Medical Center Groningen (UMCG)
Acutelines 
PO Box 30.001
9700 RB Groningen
The Netherlands

Visiting address
University Medical Center Groningen (UMCG)
Acutelines 
Hanzeplein 1
9713 GZ Groningen