T-Phases of translational health research
Translational research involves moving knowledge 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. 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 :
- T0 is characterized by the identification of opportunities and approaches to health problems.
- T1 seeks to move basic discovery into a candidate health application.
- T2 assesses the value of application for health practice leading to the development of evidence-based guidelines.
- T3 attempts to move evidence-based guidelines into health practice, through delivery, dissemination, and diffusion research.
- T4 seeks to evaluate the “real world” health outcomes of population health practice.
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?|
1- 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.