“Translational research” has been a buzzword for
several years now. One of the goals of the National Institutes of
Health (NIH) Roadmap for Medical
Research Clinical and Translational Research
Award (CTSA), which funds the Center for Clinical and
Translational Sciences (CCTS), is to make translational research an
integral part of biomedical research. The first
Request for Applications for the CTSA program defined
“translational research” as follows:
“Translational research includes two areas of translation. One is
the process of applying discoveries generated during research in the
laboratory, and in preclinical studies, to the development of trials
and studies in humans. The second area of translation concerns research
aimed at enhancing the adoption of best practices in the
community.”
This translation may seem like an automatic part of research and
medical practice, but in reality it is a major stumbling block in
science, medicine, and public health. This is partly due to the
compartmentalization of research training. Basic scientists are
not generally trained to think of the clinical application of their
work, clinicians are often not taught to formulate research studies
based on clinical observations, and public health scientists may not
have a strong background in basic or clinical research (but have the
knowledge of the community the other two groups may lack). These
three groups have long collaborated, but as our knowledge grows and
research becomes more complicated, it has become apparent that new ways
of approaching basic health problems are needed for seamless
translation. The NIH is addressing this issue through its Roadmap. The CTSA
program is a pivotal part of the Roadmap that will accelerate both
kinds of translation.
The first area of translation, from laboratory findings to
clinical practice (and visa versa—from clinical observations
back to the laboratory for further testing) is often called “bench to
bedside and back” (the motto of M. D.
Anderson’s Phase I Clinical Trials Program) or T1
translation. The CCTS is aiming to change paradigms so that
biomedical investigators and clinicians automatically include T1
translation in their day-to-day research and patient care
activities. Our goal is that the investigators and clinicians of
the future always keep in mind the purpose of the NIH: to improve
our health through research and its application.
The second area of translation, to the community and
back, is called T2 translation. T2 translation has long
been the purview of public health scientists, who study and facilitate
the application of research findings to the community. T2 translation
is the specific focus of the
CCTS’s Community Engagement Component, which works with other CCTS
Components and CCTS investigators to bring their work to the
public. In the past, T1 and T2 translation have often been
separate activities. The CTSA program and the CCTS have included
public health T2 specialists as well as laboratory and clinical
scientists to expedite the full spectrum of translation.
The CCTS’s main goal can be thought of as replacing T1 and T2
translation with one smooth and rapid process of discovery, clinical
application, and public knowledge.
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