Bridging the Gap Between Research and Practice
Unfortunately, we know that even when an intervention is proven to be efficacious and applicable, it's not always applied," says Catarina Kiefe, MD, PhD, professor of medicine and biostatistics, and director of preventive medicine at the University of Alabama at Birmingham, one of 14 new 2008 members of the CTSA consortium.
"The goal of translational research is to bring basic science findings to fruition to better the health of all people. Whereas phase 1 translational research studies the efficacy of interventions with rigid protocols and highly selected populations, phase 2 translational research [implementation research] brings the results of phase 2 studies to large populations and the 'real world,'" explains Kiefe.
"Implementation research is a subset of translational research," continues Kiefe, "and its goal is to bridge the gap between large randomized clinical trials and direct patient care and interventions.
"For example, 10 to 15 years ago, we knew that every heart attack patient should receive an aspirin as soon as they arrive in the emergency room. But only about 60% of heart attack patients were getting that aspirin. Today, it's still not up to 100%. It's probably around 90%," said Kiefe.
"This is a straightforward example, but an important one that illustrates the need for research to facilitate changes in practice patterns," Kiefe explains.
Based on implementation research, investigators play a part in facilitating generalizabilty at the community level. "Consideration must be given to defining exclusion criteria as narrowly as possible," Kiefe says. "Clinical endpoints could be more patient-oriented, as well," she adds, "using health-related quality of life measures, not just physician-defined morbidity and mortality."
How results are presented in the peer-reviewed literature is another way of facilitating incorporation of clinical research into clinical practice. "The discussion section of a paper should address the relevance of the data to clinical practice," Kiefe says. "And the methods section needs to spell out exactly what was done so the practicing clinician can determine whether the results apply to his/her patient population."
Unfortunately, we know that even when an intervention is proven to be efficacious and applicable, it's not always applied," says Catarina Kiefe, MD, PhD, professor of medicine and biostatistics, and director of preventive medicine at the University of Alabama at Birmingham, one of 14 new 2008 members of the CTSA consortium.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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