Translational research – what is it, who does it and why should we do it?

A buzz word that comes around in medical research is, “translational” research. While translational is used all time by researchers, no one seems to have a good definition for it. To borrow a famous quote: “I cannot define it, but I know it when I see it.” Wikipedia attempts to define it by saying, “Translational research is a way of thinking about and conducting scientific research to make the results of research applicable to the population.” The problem with this abbreviated definition is that population could be the scientific population, the medical population or the population of the world. But as definitions go, it is a good start.

In the medical research community the population we are often talking about is patients. But does that mean if a person is doing research on patients that it is translational? Not really because clinical research on patients may be applied research or only to some patients. See how it gets complicated.

The definition of translational research is not really what I wanted to talk about but the difficulty in defining it highlights part of the reason why it is difficult to do. If a scientist wants to do research that meets a clinical need how does one go about doing that? A good first step is to determine what the clinical needs are and if this hypothetical scientist is not a medical doctor that first step will require talking to some physicians. Here is where the fun begins.

Should that scientist talk to one physician or one thousand? One physician’s perspective might be too narrow and one thousand will take to long. Yes, this is sounding like the three bears and we want the porridge that is just right. What scientist knows and has time to talk to one thousand physicians? Just as importantly, what if the doctors you talk to have (research) needs that do not meet the skills the scientist has. Does that mean the scientist should give up research and start flipping burgers? I think not.

Okay, so I’ve posed a lot of questions and some are rhetorical. My opinion is that research, even translational research, is not a popularity contest. Everyone wants to cure cancer, but we scientists all know that there is no one cure to cancer there need to be many, so we have to carve out pieces of the research pie and some may be more “tasty” than others. Sometimes life is a crap shoot and being lucky is just as important as being good.

Back to the scientist who wants to do translational research. Now he/she is trying to meet and chat with an experienced doctor about some translational research. This would be a meeting to decide upon what that scientist might be doing and submitting a research grant to work with that physician and improve the way he/she does business when treating patients. For the scientist, this is a 5 or 10 year commitment. For the physician, it is painful to carve out ten minutes for such a meeting.

I ask the reader to ponder the above mentioned numbers for a second. A translational research scientist will commit 5 to 10 years of research to study a subject and in part base those decisions on information concerning clinical relevance from physicians. Notoriously those same physicians are hesitant to take ten minutes to participate in those discussions. They are too busy treating patients to be engaged in research to determine better ways to treat those patients.

Need I say it? That is just sad.

I do not blame the physicians; it is the system. Medical doctors are not trained to be researchers and they are generally not paid to do research. Research scientists are not trained to be physicians, so to do translational research these two groups of doctorates; MDs and Ph.Ds.,  need to meet and talk. But said meetings can be difficult to organize. The compromise that needs to be done at the level of the doctors (Ph.D., MD, DVM, D.Phil etc) is to make time to let the creative ideas flow in both directions. That time may carve into important work or need to be at less than convenient times. As an example, I have literally had a face to face with a surgeon outside of the operating room while a patient is being prepped. The nurse kept coming out to brief him on the status of the patient and he left when he was needed. I’m willing to do that as Ph.D. scientist and the surgeon was willing to squeeze out time in his schedule, which happened to be 7:00 AM on a Saturday. While non-traditional, it did give me time to talk to him and also some fodder for this blog.