SAEM Pulse May-June 2022

Page 38

Emergency Medicine Network is Forging Ahead: An Interview With Dr. Carlos Camargo


By Maurice Dick on behalf of the SAEM Research Committee


Dr. Carlos Camargo is a professor of emergency medicine, medicine and epidemiology at Harvard University, and the Conn Carlos Camargo Chair in Emergency Medicine at MGH. He founded and leads the Emergency Medicine Network (EMNet). Dr. Camargo’s research also focuses on nutrition and respiratory/allergy disorders, both in large cohort studies (e.g., the Nurses’ Health Studies) and in large randomized controlled trials; the health effects of vitamin D are a major focus. He has more than 1,100 publications with an H-index of 145. Dr Camargo is past president of the American College of Epidemiology, and has worked on several U.S. guidelines, including those on diet, asthma, and food allergy. In 2016, he received the ACEP Award for Outstanding Contribution to Research. Another important focus for Dr. Camargo is research training and mentorship; he was honored by Harvard with the Barger Excellence in Mentoring Award (2011) and by MGH with the Potts Faculty Mentoring Award (2019).

“A major factor that contributed to EMNet’s early growth and success was our open invitation to any highly motivated, detailoriented EM researcher to join us.” Can you expound on some of the challenges, gaps and or deficiencies that you encountered prior to the establishment of EMNet? At that 1996 SAEM meeting, multiple investigators expressed frustration about doing single center studies with small sample sizes, low statistical power, and potentially limited generalizability. Moreover, recruitment at only one center typically required months (sometimes years), which extended far beyond the traditional fall burst in asthma exacerbations. The long duration of these studies did not match the mindset of many emergency physicians, who typically favor shorter, simple, intense experiences — and then done! In response to this, we agreed to 24/7 enrollment of all emergency department (ED) patients with asthma exacerbations during a two-week period that fall.

Ultimately, 12 sites enrolled greater than 80% of truly consecutive patients and we collectively enrolled more than 500 patients in a few weeks. Moreover, we were able to contact more than 80% of these patients at two-week follow-up! EMNet has experienced exponential growth since inception (1996), including but not limited to, 24/7 medical centers and three distinctive programs (MARC, HSR, Social EM). What are some major factors that contributed to EMNet’s growth and success? After that initial success, we quickly grew to 77 sites and then just kept growing as we expanded our focus to other respiratory/allergy emergencies (e.g., COPD, anaphylaxis, acute respiratory infections) and developed HSR research on the heterogeneity of EDs, both in the U.S. and internationally. Major HSR studies have focused on the emergency