What is translational research?

Translational research is a relatively young field of research that includes aspects of basic research and clinical research but demands skills and resources which cannot be found in either a basic laboratory or clinical environment. The field arose mainly because of the long time it used to take to translate medical discoveries into practical treatments. Specialized journals like the American Journal of Translational Research and Translational Research have helped create awareness about the field since 2009.

The concept is explained below in greater detail.

Definition

Below is a definition of Translational health by the US National Institute for Health:

Translational research includes two areas of translation. One is the process of applying discoveries generated during research in the laboratory, and in preclinical studies, to the development of trials and studies in humans. The second area of translation concerns research aimed at enhancing the adoption of best practices in the community. Cost-effectiveness of prevention and treatment strategies is also an important part of translational science.

Translational research explained

From the above definition, it can be deduced that translational research is a broad unidirectional continuum that includes the application of research findings to both the patient and community. Thus, translational research operates a bench-to-bedside-to-community approach. Several stages of translational research have been put forward. These include a two-stage (T1 and T2), five-stage (T0, T1, T2, T3, and T4), and six-stage (T0, T1, T2, T3, T4, and T5) spectrums.

The NIH definition above is an example of a two stage translational research spectrum or continuum. In the first stage (T1), knowledge is translated from the basic research level to clinical research, while the second stage (T2) is all about the practical translation of findings from clinical studies to the outside world to increase efficiency in the health industry.

Each of the stages of the five-stage spectrum are described below.

  • T0 – involves basic biomedical research such as preclinical and animal studies but excludes trials on humans.
  • T1 – translation to human trials. Includes evidence of concept studies, the first phase of clinical trials, as well as an emphasis on innovative techniques of diagnosing, treating, and preventing health challenges in highly controlled environments.
  •  T2 – Translation to patients. Includes the second and third phases of clinical trials and controlled studies that evolve into practical clinical applications and evidence-based rules.
  •  T3 – Translation to practice. Includes studies on comparative effectiveness, post-marketing research, studies on clinical outcomes and health services as well as studies on dissemination and implementation.
  • T4 – Translation to communities. Includes studies on population-level outcomes, keeping track of morbidity, mortality, benefits, and risks as well as effects of policy and change.

The components of the six-stage spectrum (T0, T1, T2, T3, T4, and T5), are as follows:

  • T0 – Important contribution of laboratory‐based investigators at the inception of the organization.
  • T1 – New laboratory discoveries arising from new biological innovation are first translated to human applications.
  • T2 – Selected health applications from the previous stage advance through clinical development to create the evidence base for assimilation into practice guidelines.
  • T3 – New knowledge about the clinical application of discoveries in T1 and T2 must be integrated into community practices.
  • T4 – Aims to extend scientific knowledge further from algorithms of palliation treating established disease to models of disease prevention through lifestyle and behavioral changes in communities and other populations.
  • T5 – Extends beyond the public health model of care to the social health model that emphasizes improvements in the wellness of populations by changing inefficient social structures.

Goals of translational research

Translational research aims to create more beneficial and applicable practices for the health sector. The major goal of translational research is to quickly and efficiently translate or transform discoveries in basic research into practical applications/uses. 

In a nutshell, translational research seeks to:

  • Stimulate multidisciplinary partnerships among laboratory and clinical researchers
  • Sample the opinions and desires of the masses to determine their needs in relation to health innovation
  • Identify and encourage the implementation of the best medical and health practices

Relationship between basic, translational, and clinical (applied) research

Basic research is a systematic investigation aimed at acquiring improved knowledge or understanding of the fundamental attributes or characteristics of phenomena. It is driven by curiosity and not necessarily the need for immediate practical application. Basic research usually brings about a holistic understanding of nature and its laws as well as an understanding of all spheres of life such as education, industry, health, and others.

Applied research is also a systematic investigation but differs from basic research by focusing on the practical application of science to solve immediate (and future) problems. It is often considered as a logical and practical interpretation of the knowledge from basic research. In medical practice, applied research is referred to as clinical research.

Clinical research tries to determine the safety and effectiveness of new treatments, medications, and diagnostic procedures. This is usually achieved through strictly controlled clinical trials that enable physicians to accurately and precisely observe patients’ conditions and progress as well as conclude on the treatment’s strength or suitability.

Hence, whereas basic research seeks to answer questions related to nature and various phenomena/concepts, translational research aims to use (translate or apply) the knowledge derived from basic research to develop solutions for health problems. Clinical research then thoroughly examines these solutions in clinical trials. Together, the three types of research form a continuous research cycle that transforms knowledge into practical solutions such as new medications, treatments and procedures, helping to provide the most up to date innovation from the laboratory bench of the researcher to the bedside of the patient and then to the wider community.

Conclusion

Translational research aims to convert (translate) findings in basic or fundamental research into beneficial practical medical applications that help bring about overall improvements in the health industry. The end product of translational research is often a promising new medication, treatment, and/or procedure.  Translational research implements a bench-to-bedside-to-community approach, that is, from laboratory experiments to clinical trials on patients and the community-wide applications.

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