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Clinical and Translational Science: Bench to Bedside and Beyond

Pat Winokur, MD, reviewing large data array
Date: Monday, April 2, 2018

Beginning in their medical school days, physicians learn the importance of turning research findings from the lab bench into care solutions at the bedside.

Patricia Winokur, MD (88R, 91F), executive dean of the University of Iowa Carver College of Medicine and co-director—with Jeff Murray, MD, professor of pediatrics—of the Institute for Clinical and Translational Science (ICTS) at the UI, is widening the understanding at both ends of the bench-to-bedside continuum.

Launched in 2007 with a Clinical and Translational Science Award (CTSA) from the National Institutes of Health (NIH), the ICTS aims to move data collection outside the laboratory and into the lives of Iowans while enlisting the help of more community caregivers in research. The goal is new delivery models for coordinated care solutions. In late March, the NIH announced a renewal of the CTSA for approximately $20 million over five years.

Translating research to care in a rural state like Iowa presents opportunities to expand technology, build networks to train hometown health care teams, and promote greater team building among researchers from several professions. Winokur calls it “stretching ourselves beyond our borders.”

Q: What is driving changes in the way research translates into patient care?

A: New technologies. We will deliver health care in the future in a high-technology environment that captures real-time, real-life data. For many health interactions and interventions, we will use telemedicine and other technological advances. Today, using new technologies, we can help rural populations benefit from research and the new methods of health care delivery.

Q: How have our goals changed since the ICTS was established?

A: From 2007 to 2012, we focused on moving animal research into comparisons with human cells and systems. Nationally, the CTSA consortium now is concerned more with clinical research evaluating new therapies and diagnostic procedures, as well as trying to enhance the ways we perform clinical trials and then adapt new information into clinical practice. The 60 organizations that make up the country’s CTSA consortium are saying to caregivers: “Something has been learned through clinical trials that says you should change how you practice medicine.” 

Q: How might medical practice change?

A: We have an opportunity to bring research closer to home by figuring out ways people can contribute data on their health in more natural settings. For example, we can measure people’s hearing not only in a perfect environment like a sound booth but by monitoring it in their home using their smartphone to collect ambient sound. Similarly, we’ve shown how a smartphone can collect and send us blood sugar readings from pregnant moms, helping them avoid risks from diabetes during pregnancy.

Q: Is there a change in thinking that accompanies these advances in technology?

A: Let’s say your research involves understanding cellular functions. Maybe you take your results and work with an engineer to put an engineering spin on it. Or maybe you use a public health approach. We get researchers to ask: “How do I get different ways of thinking into my project from its earliest conception so this information can have different impacts?”

Q: Is it simply a matter of working in teams?

A: Teams yes, but sometimes we need to train teams to work together. We don’t necessarily talk the language of another person’s expertise. How do you get a rapport going with a team? You break down hierarchies between specialties so you are respecting different points of view from the beginning of the project.

Q: How do researchers and providers change old habits?

A: Our intent is to create graduate and undergraduate programs in translational biomedicine. We aim to improve our professionals’ skills for doing clinical and translational science. We’re committed to training mentors to be better mentors and training students to be mentored better.

Q: How do the citizens of Iowa benefit from endeavors like translational science?

A: We are focusing on moving research beyond the university’s borders and out into the state. We want rural Iowans represented in the national mix of citizens participating in research because rural populations have been underrepresented in the past. By developing better community relations with the state’s mix of private practitioners—pharmacists, physical therapists, chiropractors, nurse practitioners—we benefit all patients. Tomorrow’s care won’t be provided by physicians only. We must adapt to working with community partners because that’s who is caring for our patients on a day-to-day basis.

Q: What are the advantages with Dr. Murray as co-director?

A: Together, we represent the different types of science that fall into clinical and translational science. Jeff has focused on genetics, precision medicine, and populations around the world. He took a three-year leave from the university to serve as deputy director of the Bill and Melinda Gates Foundation. Jeff’s strong laboratory background and the public health work he’s done worldwide through the Gates Foundation are excellent complements to my work with clinical trials and the NIH Vaccine and Treatment Evaluation Unit. Jeff will oversee stakeholder engagement in the state and nation, helping bring new perspectives for our faculty and staff.