About Translational Research

"The ITHS is one of 38 medical research institutions working together as a national consortium to improve the way biomedical research is conducted across the country. The consortium, funded through the Clinical and Translational Science Awards (CTSA), shares a common vision to reduce the time it takes for laboratory discoveries to become treatments for patients, and to engage communities in clinical research efforts. It is also fulfilling the critical need to train the next generation of clinical researchers. The CTSA initiative is led by the National Center for Research Resources at the National Institutes of Health [1]."

In order to evaluate, follow and improve the impact of our efforts to advance translational research, the ITHS has adapted and embraced the multi-T phase concept of translational research, described below.

Definition of translational research

Translational research involves moving knowledge and discovery gained from the basic sciences to its application in clinical and community settings. This concept is often summarized by the phrases "bench-to-bedside" and "bedside-to-community" research.

T-Phases of translational health research

5 phases of translational research.

As the concept of translational health research has evolved with practice and time, it is clear that translational research encompasses a bidirectional continuum. For didactic purposes, translational research has often been described in phases of translation, or "T-phases." The ITHS has adopted a model of 5 phases (T0-T4), adapted from the Khoury et al. description of four phases [2]:

  • T0 is characterized by the identification of opportunities and approaches to health problems.  View the T0 toolkit.
  • T1 seeks to move basic discovery into a candidate health application.  View the T1 toolkit.
  • T2 assesses the value of application for health practice leading to the development of evidence-based guidelines.  View the T2 toolkit.
  • T3 attempts to move evidence-based guidelines into health practice, through delivery, dissemination, and diffusion research.  View the T3 toolkit.
  • T4 seeks to evaluate the “real world” health outcomes of population health practice. View the T4 toolkit.

The graphic at right shows that the 5 phases of translational research do not necessary move along a linear fashion; they often interact with each other through the entire spectrum in no particular order.

Example of T0-T4 translational health research

The following example is adapted from Khuory et al (2):

Research Phase Definition Type of Research Examples
T0 Identification of opportunities and approaches to health problem. Basic research question Are there specific gene mutations associated with breast cancer?
T1 Discovery of candidate health application Phase I and II clinical trials; observational studies Is there an association between BRCA mutations and breast cancer?
T2 Health application to evidence-based practice guidelines Phase III clinical trials; observational studies; evidence synthesis and guidelines development What is the positive predictive value of BRCA mutations in at-risk women?
T3 Practice guidelines to health practices Dissemination research; implementation research; diffusion research Phase IV clinical trials What proportion of women who meet the family history criteria are tested for BRCA and what are the barriers to testing?
T4 Practice to population health impact Outcomes research (includes many disciplines); population monitoring of morbidity, mortality, benefits, and risks studies Does BRCA testing in asymptomatic women reduce breast cancer incidence or improve outcomes?

The ITHS supports research throughout the translational continuum, as illustrated in these examples:
• Infectious disease (.doc), Infections disease T-phase diagram (.jpg)
• Biobehavioral interaction in Chronic Conditions (.doc), Depression T-phase diagram (.jpg)

References

1 - excerpt from http://www.ctsaweb.org/docs/CTSA+description.pdf
2 - Khoury MJ. et al. The continuum of translation research in genomic medicine: how can we accelerate the appropriate integration of human genomic discoveries into health care and disease prevention? Genet Med 2007:9(10):665-674.

 

Last modified: June 1, 2009