Friday, January 6, 2012

What is "Translational Medicine"?

Translational Medicine is a new paradigm of streamlined efforts that have previously-existed. It is nothing new. However, the term denotes a shift in methodology so that patients and doctors can implement new drugs, new technology and turn it into a Doctor's Order that is used at the patient's bedside.

In the traditional paradigm, the clinician-scientist first gathers preliminary data. After going through an Institutional Review Board (IRB), a research Investigation begins. Blood samples, urine samples, blood pressure, or any other variable is tracked. The research intervention is then implemented (e.g., dose of drug, change in ventilator settings). Afterward, additional data is analyzed to finalize whether or not the intervention was clinically useful or not.

To this end, the blood samples for example, are taken into the laboratory of a researcher who already has funding, a long history of research, and is able to collaborate to 'let' the clinician-scientist 'use' the researcher's laboratory for blood sample analysis. This researcher is usually well-known in the field of expertise, has published research abstracts for live presentation at scientific conferences, and has published research manuscripts in professional journals. The long-sought after RO1 NIH grant has already been achieved, and the clinician/scientist is collaborating with the researcher to use her/his lab.

The clinician/scientist walks in from the patient's bedside with a vial of blood, and carries it to the researcher. The researcher performs analysis specific to her/his field, and then the resulting data are analyzed. Together, the clinician/scientist and the Researcher overview the research findings, and make research conclusions together. Thus, a research 'result' is generated in a minute amount of time, versus the traditional model.

In the traditional model, the clinician/scientist has her/his own laboratory with NIH funding. Perhaps a Ph.D. has assisted in the research endeavor and is a Co-Investigator on the grant proposal. It can take one year to submit an Application for an RO1 NIH grant, and then the process may likely result in an initial rejection. With the rejection comes a critique of the research protocol, including the intentions of the research protocol in coming up with a conclusion that is significant.

So the new way of Translational Medicine transcends the old model by allowing the clinician/scientist to collaborate with already-existing and fully-functioning, active laboratories that are publishing articles. In this way, the clinician/scientist may translate bedside information into a laboratory specimen, translate the processing of the specimen to a research conclusion, and then go back to the patient's bedside to have a more precise method of implementing clinical care that will make a difference.

There are many other illustrations of Translational Medicine in practice, but this is just one example for your understanding. No longer does the clinician/scientist have to wait until she/he sets up her/his own laboratory, complete with NIH funding, test tube vials, centrifuges, assays, or electron microscopy.

It is more like a waltz. The clinician/scientist 'waltzes' in to the already-established laboratory, drops off a specimen, and waits for results. Then, the clinician/scientist and the Researcher publish the results and personally share them at scientific meetings so that further collaboration, input, and critique are made. Finally, the results are concluded so that an intervention is made at the bedside, and the results of that intervention are acquired in a minimum time frame.

Let us prepare for this waltz, so that we do not step on any toes. Let us do our homework, learn the steps, and then do it. There is no other way to learn how to dance than to do it. We must implement scientific advances together with our colleagues that are the bench-researchers extraordinaire.

Translational Medicine is the future. It is not new. Many researchers have accelerated clinical science and their own professional careers by accelerating advances in medicine through significant collaboration with researchers in their field. Let us watch Translational Medicine evolve and grow as we move toward promoting the concept.

And let us thank those who recognize the significance of its value. 

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