That means rethinking how research is approached and how future researchers learn. National leaders say the approach will reshape American health care into predictive, preventive and personalized medicine.
“There have been unprecedented advances in biomedical research over the past decade,” says
Dr. Frank Treiber, vice president for research and
associate provost at the Medical College of Georgia.
“These advances need to be brought together to reach their full potential in improving public health.”
He cites the development and synergy of fields including genomics to identify combinations of genes responsible for disease; biomedical imaging and biomarkers to better identify disease risk and monitor treatment; and bioinformatics to integrate and analyze information.
“The National Institutes of Health is seeing a need to provide institutions with resources to help researchers from these disciplines work together efficiently to enhance the efficiency and speed of bringing scientific advances to the public,” says Dr. Treiber.
MCG sees it as well.
Last year, senior leaders made a high priority of expanding and transforming clinical and translational research for its five-year strategic research mission.
This October, MCG was among 52 universities to receive a one-time NIH planning grant to prepare for an institutional Clinical and Translational Science Award. A dozen universities received CTSAs in the first round of funding.
NIH says these awards will:
- Nurture a cadre of well-trained, multidisciplinary and interdisciplinary investigators and research teams
- Create an incubator for innovative research tools and information technologies
- Synergize multidisciplinary and interdisciplinary clinical and translational research
“We competed well with other institutions that have some components already in place that we do not,” says Dr. Treiber. “We showed the NIH that we have significant areas of clinical research strength addressing the leading causes of premature mortality and disability in Georgia and the nation. We showed how we will continue to build the infrastructure necessary to make significant contributions in clinical and translational science and to prepare the next generation of biomedical researchers and health care providers.”
The
$220,000 one-year grant will strengthen translational work in cardiovascular
disease, stroke, diabetes and cancer, major health concerns for all Georgians
and particularly for minority and ethnic populations. MCG also
is establishing certificate and master’s-level programs in clinical science
and translational research.
“If we are going to become a top-tier academic medical center, we need to do more to integrate our basic scientists, physician-scientists, nurse researchers and other behavioral scientists with other clinical investigators,” says Dr. Treiber. “We must expand our biostatistics, bioinformatics and epidemiology capabilities and, most importantly, provide the research infrastructure and environment needed to allow these researchers from diverse disciplines to work with each other. We have to create a new home for people to cross disciplines, departments, centers, institutes and schools, and they have to be rewarded for doing that. Some of this is already happening, but we will continue to nurture it so that it mushrooms and leads to our ability to compete for a prestigious CTSA in the next several years.”
In recent years, MCG has seen unprecedented research activity on campus, including defining areas of focus, expanding research teams, opening two research buildings, strengthening core laboratory facilities and establishing a Department of Biostatistics to help gather and assess findings. But the shifting sands of research in the country require even more.
“The goal of this planning grant is to ask experts, ‘If you were to design a system that would accelerate the transition of basic science insights and physiological insights to improve public health, how would you do it? If you were to design a system to train clinical translational scientists for the future, how would you do it?’” says Dr. Guy Reed, chief of the MCG Section of Cardiology and working group leader for the CTSA planning grant.
Dr. Reed, who researches ways to dissolve dangerous clots, knows firsthand that if the system isn’t broken, it’s at least in need of major renovation.
“It’s sort of an unnatural fit for a clinician,” says the Georgia Research Alliance Eminent Scholar in Cardiovascular Disease. “You have to cross-train in two worlds, and one world doesn’t really understand the demands of the other very well.” CTSA initiatives enable institutions to find more common ground for these ‘parallel universes’ that develop during training and extend through practice, says Dr. Reed. “This gives MCG the opportunity to marshal its strengths.”
Using his own area of cardiovascular disease as an example, he runs down a list of research strengths in the Department of Physiology, the Vascular Biology Center, the Georgia Prevention Institute and the Department of Pharmacology and Toxicology.
“The planning grant aims to bring together those strengths and link them with clinical interest, research and training. The grant allows us to think about creating ways to bring in Ph.D. candidates, M.D. candidates, nursing students and allied health students, [helping them] acquire research skills and apply those skills toward questions they will face with their patients.”
“One of the stumbling blocks is trying to translate what you find in the lab to the clinic,” says Dr. Richard A. McIndoe, bioinformatics expert, associate director of the MCG Center for Biotechnology and Genomic Medicine and a CTSA working group leader. “A big chunk is informatics. How are we going to securely and anonymously access clinical information? How are we going to analyze it? How can we use that information to move science forward? Translational centers facilitate going from bench to bedside.”
He
concurs that establishing common ground and language should work wonders. “The
idea is we can train clinicians in science and also interact with scientists in
a clinical setting so they start talking each other’s languages.”
“All research institutions in the country are moving in this direction,” says Dr. Varghese George, chair of the MCG Department of Biostatistics, who is overseeing the educational training and career development component of the CTSA planning grant. “NIH is pushing for it. If you are going to be competitive in the field, you have to do this.”
His group already is gleaning the best of existing training programs, which number less than 40, and planning one for MCG. He envisions one year of didactic coursework covering epidemiology, biostatistics, research methods, responsible research conduct and scientific communication as well as how to design studies, analyze data and translate it into publishable scientific conclusions. The first year will conclude the certificate program. For the master’s, a second year will include research training, co-mentored by clinical science and biostatistics faculty.
Young clinicians, including new faculty and possibly fellows, are likely students. The training programs, which should be available next fall, probably will be faculty recruitment tools. “Young faculty who want to really be competitive will want to have some of this training,” Dr. George says. “They should be able to submit a grant proposal by the time they finish the two-year program.”
- Toni Baker