Types of translational research

From The Meaning of Translational Research and Why It Matters, by Steven H. Woolf:

  • “The first roadblock (T1) was described by the roundtable as ‘the transfer of new understandings of disease mechanisms gained in the laboratory into the development of new methods for diagnosis, therapy, and prevention and their first testing in humans.’ The roundtable described the second roadblock (T2) as ‘the translation of results from clinical studies into everyday clinical practice and health decision making.'”
  • “T1 research requires mastery of molecular biology, genetics, and other basic sciences; appropriately trained clinical scientists working in strong laboratories and with cutting-edge technology; and a supportive infrastructure within the institution […]. In contrast, the ‘laboratory’ for T2 research is the community and ambulatory care settings, where population-based interventions and practice-based research networks bring the results of T1 research to the public. T2 requires different research skills: mastery of the ‘implementation science’ of fielding and evaluating interventions in real-world settings and of the disciplines that inform the design of those interventions, such as clinical epidemiology and evidence synthesis, communication theory, behavioral science, public policy, financing, organizational theory, system redesign, informatics, and mixed methods/qualitative research. T1 and T2 face different challenges. T1 struggles more with biological and technological mysteries, trial recruitment, and regulatory concerns. T2 struggles more with human behavior and organizational inertia, infrastructure and resource constraints, and the messiness of proving the effectiveness of ‘moving targets’ under conditions that investigators cannot fully control.”
  • “T1 seems to over-shadow T2 in the United States. Most individuals have T1 in mind when they use the term translational research and T1 attracts more funding.
  • “Arguably, the federal responsibility for T2 research lies not with the NIH but with the Agency for Healthcare Research and Quality (AHRQ). According to its recent report to Congress, ‘the ultimate goal [of AHRQ] is research translation—that is, making sure that findings from AHRQ research are widely disseminated and ready to be used in everyday health care decisionmaking.'”
  • “How attention and resources are apportioned to T1 and T2 matters because, for many diseases, T2 could save more lives than T1.
  • “At a time when experts warn of the fragmented health care system and of a widening ‘chasm’ in access, quality, and disparities, interventions to close these gaps—the work of T2—may do more to decrease morbidity and mortality than a new imaging device or class of drugs.”


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