Bench to Bedside

By Anna Lynn Spitzer

Dr. Kristen Kelly (right) treats a patient during a clinical trial for treating port-wine stain birthmarks. With her are graduate student researchers Owen Yang (left), and Bruce Yang, who is funded by an ICTS training grant. (Photo: Paul Kennedy)

Irvine, Ca, December 5th, 2012 -- In one corner: research scientists toiling on technologies to tackle perplexing biomedical problems.

In the other corner: doctors searching for efficient remedies while treating patients and juggling paperwork.

Between them: the so-called “valley of death,” brimming with institutional and cultural obstacles that impede the mutual benefit to be gained from collaboration.

The National Institutes of Health is building bridges over this barren landscape. Through its Clinical and Translational Science Awards program, it is moving innovation “from bench to bedside” by connecting academic researchers who conceive advanced technologies and methodologies with clinical practitioners who can test their effectiveness in real patients.

UC Irvine’s Institute for Clinical and Translational Science (ICTS) is one of 60 CTSA centers nationwide. Funded by a $20 million, five-year award, ICTS offers clinical services, workshops, grants and a host of other opportunities that help create tangible links between clinicians, academic researchers and the community.
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“There is no one definition of translational science,” says Margaret Schneider, ICTS director of evaluation and tracking. “The essential kernel, though, is that it’s translating discoveries made at the laboratory level into innovations in patient care. You’re crossing this spectrum from highly controlled experiment to making a difference to individuals in the community.”

t's often problematic. “Scientists have their own area of expertise and they speak their own vocabulary. So communication between the basic scientist and the clinical researcher can sometimes be very difficult,” she says.

ICTS strives to overcome these challenges and facilitate cross-disciplinary partnerships and clinical trials. “We try to encourage and empower individual investigators,” says ITCS Director Dr. Dan Cooper. “We make sure the whole enterprise applauds and rewards innovation. We celebrate team science, where people exchange ideas in a free and open manner, knowing that in terms of scientific discovery, sharing is more important than owning.”

Community is crucial. At ICTS, a community action planning group comprising 25 organizations meets quarterly to plan a series of workshops as well as an annual community awards dinner.

Human trials are underway for a tele-rehab application supported by ICTS. Neurologist Dr. Steve Cramer and therapist Lucy Dodakian help patient Jeanne O'Shea as she strengthens ahnd function by playing computer games. (Photo: Paul Kennedy)

One such workshop held recently in Santa Ana addressed a concept known as “community-based participatory action research,” attracting more than 30 people from a diverse cross-section of organizations. 

Participants listened attentively as Dr. Michael Montoya, ICTS director of research for community engagement, explained ICTS’s objective. “Our goal is to take scientific knowledge from bench to bedside by working across disciplines to create healthcare changes more quickly,” he said.

Across the University of California, similar efforts are underway on each of the five medical school campuses. All are part of an initiative called UC BRAID (Biomedical Research Acceleration Integration and Development), that facilitates and accelerates biomedical clinical and translational research across the university system.

UC BRAID has developed a “Trust and Rely” arrangement that spans the five campuses’ Institutional Review Boards.  Clinical trials approved at one campus can be conducted at any of the five medical centers without submitting to new campus-specific institutional review procedures. “This really helps encourage collaboration across the university,” Schneider says.

It’s also developing an “honest broker” system, which allows researchers to pull relevant study data from UC medical records while keeping patients’ identities confidential.

Last year, more than 500 investigators attended workshops, received grants or used an ICTS service. “We try really hard to work across boundaries,” says Lisa Hinojosa, research operations director, by providing researchers a place to “come to the table and discuss things and see what can come of it. Sometimes people approach problems one way but after hearing different perspectives, they’re open to taking a different route.”

Cooper is pleased with the center’s progress, especially during current tough budgetary times. “I think we’ve done a really good job of creating a nimble, flexible, supportive, responsive infrastructure,” he says. “We help people design studies, connect with other individuals in meaningful ways, find mentors and we help fund trainees.”