Bench to Bedside - Translational Medicine Flashcards
What is translational medicine?
The process of turning observations in the laboratory, clinic and community into interventions that can improve the health of individuals and the public.
From diagnostics and therapeutics to medical procedures and behavioral changes - national center for advancing translational sciences.
What coordinates translational medicine in the USA and Australia?
NIH in USA
NHMRC in Australia
What are the stages of translational medicine? How is the stage progression between stages?
Spectrum from T0 to T4
T0 = basic biomedical research
T1 = translation to human
T2 = translation to patients
T3 = translation to practice
T4 = translation to communities
Not a linear progression of one stage to the next
Each step feeds back on the previous stages, translating basic discoveries all the way up to population health, implementation and improvement, gaining insights that can be applied backwards and forwards
What kind of research is done in T0?
Preclinical and animal studies. Defining mechanisms, targets, and lead molecules.
What kind of research is done in T1?
Proof of concept in phase 1 clinical trials. New methods of diagnosis, treatment, and prevention.
What kind of research is done in T2?
Phase 2 and phase 3 clinical trials. Controlled studies leading to effective care.
What kind of research is done in T3 and T4?
Implementation research. In these stages data is translated into practice and community allowing for delivery of recommended and timely care to the right patient to create a true benefit to society.
What is the purpose of T0, T1, and T2?
Translation from basic science to human studies.
What is basic science research?
Fundamental or “bench” research.
It is the foundation for all subsequent stages of research
In this stage basic research involves exploration that can reveal fundamental mechanisms of biology, disease or behaviour.
Every stage of translational research spectrum builds upon and informs basic research.
How is basic science research translated to humans (T1)?
Using discoveries on human cells/tissues or other human models pre-clinically.
Example of this is testing a new anti-cancer drug on tumour cells in a petri dish
How is clinical data translated to patients (T2)?
Movement of discoveries into patients via clinical trials.
What does clinical research include?
Clinical research includes;
Studies to better understand a disease in humans, and to relate these findings to observed in animal or cell models of the disease.
Testing new treatments for toxicity and efficacy on healthy people and ill people for whom no other treatment exists.
Behavioural and observational studies
Testing new treatments for toxicity and efficacy, on healthy people and ill people for whom no other treatment exists.
How can information be translated to practice after translation to humans and patients? (T3)
Involves adoption of interventions that have been demonstrated to be useful in research setting into routine clinical care for the general population.
Also includes evaluation of the results of clinical trials and to identify new clinical questions and gaps in care.
What kinds of therapies emerge at the T3 stage?
Therapies that emerge from the Dr’s office:
Pregnancy testing
Genetic testing
New drugs
New diagnostics, imaging and medical devices
Example of question asked in the T3 stage:
What is the proportion of women who meet the family history criteria are tested for BRCA and what are the barriers to testing?
