Western Emergency Services Translational Research Network

The Western Emergency Services Translational Research Network (WESTRN) is a consortium of emergency medicine researchers at sites with Clinical Translational Science Awards (CTSA) in the western United States. The consortium’s objective is to conduct high quality multicenter research focused on important emergency medicine issues. 

Oregon Clinical and Translational Research Institute          

Stanford/Packard Center for Translational Research in Medicine  

UC Davis Clinical and Translational Science Center

UC Irvine Institute for Clinical & Translational Science

UC San Diego Clinical and Translational Research Institute

UCSF Clinical & Translational Science Institute

Colorado Clinical and & Translational Sciences Institute

University of New Mexico Clinical and Translational Science Center

Southern California Clinical and Translational Science Institute

University of Utah Center for Clinical and Translational Science

University of Washington Institute of Translational Health Sciences



Email Address

OHSU                                     * Craig Newgard, M.D., M.P.H. newgardc@ohsu.edu
Stanford University Kristan Staudenmayer, M.D. kstaudenmayer@yahoo.com
  * Ewen Wang, M.D.                  ewen@stanford.edu 
  James Quinn, M.D. quinnj@stanford.edu
UC Davis                     Deborah Diercks, M.D., M.S.  dbdiercks@ucdavis.edu
  * James Holmes, M.D., M.P.H. jfholmes@ucdavis.edu 
  Nathan Kuppermann, M.D., M.P.H. nkuppermann@ucdavis.edu
  Daniel Nishijima, M.D., M.S. daniel.nishijima@ucdmc.ucdavis.edu
UC Irvine * Mark Langdorf, M.D. milangdo@uci.edu
  Shahram Lotfipour, M.D. shl@uci.edu
UC San Diego * Gary Vilke, M.D. gmvilke@ucsd.edu
UC San Francisco * Renee Hsia, M.D. renee.hsia@emergency.ucsf.edu
  Robert Rodriguez, M.D. robert.rodriguez@emergency.ucsf.edu
  Preston Maxim, M.D. preston.maxim@emergency.ucsf.edu
University of Colorado/Denver * Jason Haukoos, M.D. Jason.Haukoos@dhha.org
  Jody Vogel, M.D. Jody.Vogel@dhha.org
University of New Mexico Cameron Crandall, M.D. ccrandall@salud.unm.edu
  *Jon Femling, M.D., Ph.D. JFemling@salud.unm.edu
University of Southern California * Sean Henderson, M.D. sohender@usc.edu
University of Utah Erik Barton, M.D. erik.barton@hsc.utah.edu
  * Troy Madsen, M.D. troy.madsen@hsc.utah.edu
  Christopher Gee, M.D. christopher.gee@hsc.utah.edu
  N. Clay Mann, Ph.D. Clay.Mann@hsc.utah.edu
University of Washington Sue Stern, M.D. sstern@medicine.washington.edu
  * Nathan White, M.D. Nwhite07@hotmail.com
  Tom Rea, M.D., M.P.H.  
  Eileen Bulger, M.D.  
  * Primary contact for site  

Current and Past Research Projects (chronological order)

1.  Prehospital Trauma Study: 
The study objective is to evaluate the current prehospital trauma triage guidelines and potentially develop new guidelines that better match patient clinical and resource needs with hospital resource available. Cost implications and cost effectiveness of different approaches to field triage will also be evaluated. The initial field triage study in WESTRN was retrospective, and was followed by a prospective cohort study (in progress).

2.  Variability in Intensive Care Unit Utilization in Patients with Blunt Head Trauma:
Patients with minor traumatic intracranial hemorrhage are frequently admitted to the intensive care unit, although many never require critical care interventions. We will describe critical care resource utilization in minor traumatic intracranial hemorrhage by the following objectives: 1) evaluating the variability of ICU utilization in a cohort of patients with minor traumatic brain hemorrhage across multiple trauma centers and 2) the proportion of adult patients with traumatic brain hemorrhage admitted to the intensive care unit who never receive a critical care intervention during hospitalization.

3.  Validation of the Denver Trauma Organ Failure Score: 
The Denver Trauma Organ Failure Score was derived to identify trauma patients in the emergency department are at risk for multi-organ failure. This prospective study will enroll over 2,000 patients at 3 sites (Denver Health, UC Davis and OHSU) to validate the prior scoring system.

Published Abstracts:

  1. Newgard CD, Zive D, Rea T, Bulger E, Holmes J, Liao M, Staudenmayer K, Hsia R, Wang NE, Sporer KA, Fleischman R. A Multi-Site Assessment and Validation of the ACSCOT Trauma Triage Criteria for Identifying Seriously Injured Children and Adults. [Abstract] Ann Emerg Med. 2010;56(3):S28.
  2. Newgard CD, Rea T, Bulger E, Fleischman R, Wang NE, Hsia R, Warden C, Liao M, Sahni R, Mann NC, Kuppermann N. Development of a Pediatric Field Trauma Triage Algorithm For Identifying Children With Serious Injuries or Need For Major Surgical Intervention. [Abstract] Circulation. 2010;122:a298.
  3. Newgard CD, Zive D, Bulger E, Rea T, Fleischman R, Staudenmayer K, Liao M, Schmidt T, Wittwer L, Hsia R, Barton E, Holmes J. Matching Trauma Triage Criteria to Adult Age: Development of Field Triage Guidelines for Identifying High-Risk Young and Older Adults. [Abstract] Circulation. 2010;122:a158.
  4. Newgard CD, Kampp M, Nelson M, Zive D, Bulger E, Rea T, Liao M, Sherck J, Hsia R, Fleischman R, Heineman J, Barton E, Daya M, Kuppermann N. Deciphering the Predictive Value and Use of “EMS Provider Judgment” in Out-of-Hospital Triage: A Multi-site, Mixed Methods Assessment. [Abstract] Acad Emerg Med. 2011;18:s24.
  5. Newgard CD, Bulger E, Liao M, Staudenmayer K, Hsia R, Fleischman R, Holmes J, Mann NC, Gorman K, McConnell KJ. The Cost of Trauma Triage: A Multi-Site Evaluation of the Downstream Costs of Out-of-Hospital Triage Within and Between Hospitals. [Abstract] Acad Emerg Med. 2011;18:s138.
  6. Staudenmayer K, Wang NE, Hsia R, Ghilarducci D, Spain DA, Mackersie R, Kline R, Sporer K, Newgard CD. The forgotten trauma patient: Outcomes for injured patients evaluated by EMS but not transported. [Abstract] American Association for the Surgery of Trauma. (presented 9/15/2011)
  7. Nishijima D, Haukoos J, Staudenmayer K, White N, Newgard CD, Gee C, Holmes JF. Variability and efficiency of intensive care unit utilization in adult patients with traumatic intracranial hemorrhage. [Abstract] Acad Emerg Med. 2012. (In Press)
  8. Fleischman R, Mann NC, Wang NE, Hsia RY, Rea TD, Liao M, Holmes JF, Newgard CD. Validating The Use Of ICD9 Codes To Generate Injury Severity Score: The ICDPIC Mapping Procedure. [Abstract] Acad Emerg Med. 2012. (In Press)
  9. Nakamura Y, Daya M, Schreiber M, Bulger EM, Mackersie R, Hsia RY, Mann NC, Holmes JF, Staudenmayer K, Sturges Z, Liao M, Haukoos J, Kuppermann N, Barton ED, Newgard CD. Evaluating Age in the Field Triage of Injured Persons. [Abstract] Acad Emerg Med. 2012. (In Press)
  10. Newgard CD, Kuppermann N, Mann NC, Haukoos J, Staudenmayer K, Sahni R, Ma OJ, Hsia R, Bulger E. Understanding Under-Triage in Trauma: The Roles of Age and Patient Preference in EMS Transport Patterns. [Abstract] Acad Emerg Med. 2012. (In Press)

Manuscripts published or in press:

  1. Newgard CD, Zive D, Holmes JF, Bulger EM, Staudenmayer K, Liao M, Rea T, Hsia RY, Ewen NE, Fleischman R, Jui J, Mann NC, Haukoos JS, Sporer KA, Gubler KD, Hedges JR. A Multi-Site Assessment of the ACSCOT Field Triage Decision Scheme For Identifying Seriously Injured Children and Adults. J Am Coll Surg. 2011;213:709-721.
  2. Newgard CD, Kampp M, Nelson M, Holmes JF, Zive D, Rea T, Bulger EM, Liao M, Sherck J, Hsia RY, Wang NE, Fleischman RJ, Barton E, Daya M, Heineman J, Kuppermann N. Deciphering the Use and Predictive Value of “EMS Provider Judgment” in Out-of-Hospital Trauma Triage: A Multi-site, Mixed Methods Assessment. J Trauma. 2012. (In Press)
  3. Newgard CD, Malveau S, Staudenmayer K, Wang NE, Hsia RY, Mann NC, Holmes JF, Kuppermann N, Haukoos JS, Bulger EM, Dai M, Cook LJ. Evaluating the Use of Existing Data Sources, Probabilistic Linkage and Multiple Imputation to Build Population-Based Injury Databases Across Phases of Trauma Care. Acad Emerg Med. 2012. (In Press)
  4. Staudenmayer K, Hsia RY, Wang NE, Sporer K, Ghilarducci D, Spain D, Mackersie R, Kline R, Sherck J, Newgard CD. The Forgotten Trauma Patient:  Outcomes for Injured Patients Evaluated by Emergency Medical Services but not Transported to the Hospital. J Trauma. 2012;72:594-600.
  5. Nakamura Y, Daya M, Bulger EM, Schreiber M, Mackersie R, Hsia RY, Mann NC, Holmes JF, Staudenmayer K, Sturges Z, Liao M, Haukoos J, Kuppermann N, Barton ED, Newgard CD. Evaluating age in the field triage of injured persons. Ann Emerg Med. 2012. (In Press)
  6. Nishijima D, Haukoos J, Newgard CD, Staudenmayer K, White N, Slattery D, Maxim PC, Gee C, Hsia RY, Melnikow JA, Holmes JF. Variability of ICU utilization in adult patients with minor traumatic intracranial hemorrhage. Ann Emerg Med. 2013. (In Press)

Research Study Proposal Submission Process

This document outlines the process for submission of and participation in research protocols in the West Coast Emergency Services Translational Research Network (WESTRN). As current participation in this research network is voluntary, there is no formal requirement for a site to participate in proposed studies. All sites, however, are encouraged to participate. The process for submitting study proposals is open to all emergency care providers at participating WESTRN sites. The following information is required for protocol submission and approval (including secondary analyses of databases already assembled by the network).


The study proposal must address the following points:

·        Investigator name & contact information

·        Working title

·        Importance of the proposed topic

·        Justification for the need of an EM network to study the problem

·        Background (brief)

·        Specific Aims and Hypothesis

·        Methodology

o   Study type/design

o   Inclusion and exclusion criteria

o   Primary and Secondary outcome measures

o   Variables collected

o   Analytic plan (including who/where analysis will be performed)

o   Sample size calculation

·        Authorship statement: 1-2 investigators from each participating site as writing group (WG) members (maximum total = 15); co-authorship on resulting abstracts/manuscripts contingent on site data contribution and active participation in the WG (site-specific individuals to be listed following circulation of the proposal to all sites).

·        Timeline:  it is expected that data analysis, manuscript preparation, and submission will be completed within 12 months of completing data collection.

·        Resource requirements, including:

o   resources required from each site

o   funding (if applicable): targeted funding source, RFA, PA or other relevant information


Format: Two page limit (excluding author list, timeline, and resource requirements).


Data Use:  Unless agreed upon by all participating sites, results will be reported in aggregate, without identification of specific hospitals or sites. Recognizing the potential sensitivity of data, all sites must agree to use of their data (including the process for where and how data analyses will be undertaken) before analyses are conducted. This process includes secondary data analyses. Where required, IRB protocols may need to be submitted (or addendums added).


Principal Investigator/WG Facilitator responsibilities:  The WG Facilitator is responsible for all phases of study development and manuscript preparation (conception through publication), including:


·        Preparation of protocol for submission;

·        Contacting WG members to discuss the protocol, data analysis plan, responsibilities of each member, and resulting manuscript, including clear deadlines for completion;

·        Preparation and circulation of drafts for approval by each member of the WG before journal submission;

·        Determination of the order of authorship on the manuscript based on effort and contribution;

·        Choice of a journal to which the manuscript will be submitted;

·        Responsible use and reporting of data;

·        Ongoing correspondence with coauthors and the larger WESTRN consortium.


Trainees:  The WESTRN consortium supports the training and development of future emergency care investigators and welcomes their involvement in study protocols, provided there is a “sponsoring” site-based investigator (i.e., mentor) to oversee, supervise, and take responsibility for their work.


Author listing:  Up to 15 writing group members will be listed as authors, provided they meet standard criteria for authorship.  All papers should include the phrase “and the XXXX Study Group for the WESTRN Network” at the end of the author group, with non-WG contributors listed in the acknowledgments section (provides opportunity for non-WG contributors to list on CV).


Submission:  Please submit the initial protocol to James Holmes (jfholmes@ucdavis.edu) who will facilitate circulation among the group.


Standard Template for Referencing WESTRN

This project was supported by the Oregon Clinical and Translational Research Institute (grant # UL1 RR024140); UC Davis Clinical and Translational Science Center (grant # UL1 RR024146); Stanford Center for Clinical and Translational Education and Research (grant # 1UL1 RR025744); University of Utah Center for Clinical and Translational Science (grant # UL1-RR025764 and C06-RR11234); and UCSF Clinical and Translational Science Institute (grant # UL1 RR024131).  All Clinical and Translational Science Awards are from the National Center for Research Resources, a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research. 

For further information or questions, please contact:

Craig Newgard, M.D., M.P.H.         newgardc@ohsu.edu
James Holmes, M.D., M.P.H.         jfholmes@ucdavis.edu