“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.