Changing models of biomedical research

The Challenges and Opportunities of Translational Pathology

Translational pathology has not caught up with the quality and quantity of translational medicine. Thus, challenges and opportunities related to translational pathology are discussed here. Pathologists should actively participate in reverse translational research that seeks mechanistic insights to explain clinical findings and/or solve clinical problems. Challenges in translational pathology include ambiguity in defining translational pathology, pathologists' mindsets about translational research, lack of sufficient workforce and immature publication outlets. However, with collective wisdom and support of various stakeholders, we can expand the pool of pathologist scientists, build a translational pathology community and drive innovations in medicine through computational, molecular genetic/genomic and digital pathology approaches.

Collaboration versus outsourcing: the need to think outside the box

As has been widely reviewed elsewhere, the pharmaceutical industry is experiencing an ‘innovation deficit’ as evidenced by the decline in new chemical entity output. This decline, compounded by increased costs and regulatory requirements highlights the need to significantly revise strategic options across the drug-discovery spectrum. Within such revision(s), much of the focus has been on outsourcing to reduce, or at least contain, costs, but if the underlying predominance of ‘closed collaborations’ is not challenged to allow better use of combined knowledge and, thus, move towards a more genuine collaborative process then a ‘numbers only’ approach will not bring medium-to-long-term survival. There are many problems to confront in evolving new sustainable strategies, a real need to think differently exists and should to be cultivated. This article reviews current outsourcing and collaboration strategies to provide a perspective on how great knowledge sharing could help revise the drug-discovery process.

Detection and characterization of translational research in cancer and cardiovascular medicine

Background

Scientists and experts in science policy have become increasingly interested in strengthening translational research. Efforts to understand the nature of translational research and monitor policy interventions face an obstacle: how can translational research be defined in order to facilitate analysis of it? We describe methods of scientometric analysis that can do this.

Methods

We downloaded bibliographic and citation data from all articles published in 2009 in the 75 leading journals in cancer and in cardiovascular medicine (roughly 15,000 articles for each field). We calculated citation relationships between journals and between articles and we extracted the most prevalent natural language concepts.

Results

Network analysis and mapping revealed polarization between basic and clinical research, but with translational links between these poles. The structure of the translational research in cancer and cardiac medicine is, however, quite different. In the cancer literature the translational interface is composed of different techniques (e.g., gene expression analysis) that are used across the various subspecialties (e.g., specific tumor types) within cancer research and medicine. In the cardiac literature, the clinical problems are more disparate (i.e., from congenital anomalies to coronary artery disease); although no distinctive translational interface links these fields, translational research does occur in certain subdomains, especially in research on atherosclerosis and hypertension.

Conclusions

These techniques can be used to monitor the continuing evolution of translational research in medicine and the impact of interventions designed to enhance it.

Analysis of the workforce and workplace for rheumatology and the research activities of rheumatologists early in their careers

OBJECTIVE

To assess the workforce and workplace in rheumatology, and the research work of early-career rheumatologists.

METHODS

Early-career rheumatologists were defined as practicing physicians who joined the American College of Rheumatology (ACR) in 1991-2005, were 49 years of age or younger when they joined, and reside in North America. This cohort participated in a Web-based survey distributed by the ACR. A total of 247 surveys (21.2% response) were used for this analysis. Survey questions were designed to obtain core insights about the workforce, workplace, research activities, funding, and the demographic profile of respondents.

RESULTS

Respondents from all workplaces-clinical, academic, federal, and industry-engaged in clinical care, teaching, administration, and research. The time devoted to these tasks was employer dependent, and workplaces shaped the scale and scope of research. Patient-oriented research was predominant across all workplaces. Disease, population, and translational research were intermediate, and few respondents pursued basic or prevention-oriented research in any type of workplace. Rheumatologists obtained extramural funds (21.3%) and intramural funds (78.7%) to pay portions of their salaries for time spent on research. Receiving a National Institutes of Health K08/K23 award was associated with receipt of a federal research project grant (P < 0.001). Respondents associated investigative work with reduced earnings, a perception validated by an estimated drop in pre-tax annual earnings of 2.3% for each half-day/week dedicated to research (P < 0.01).

CONCLUSION

The results of this study justify interventions for closing gaps embedded in investigational rheumatology. These include improved funding for clinical research, increasing the number of K08/K23 awards, and recruiting rheumatologists from underrepresented demographic groups.