Time lags in the translation of medical research: Developing a case study approach to achieve a better understanding

医学研究中的一个主要挑战是如何最好地确保研究成果有效地从病床上转移到床边，并付诸实践，使患者受益。研究表明，目前在英国，新发现通常需要17年才能付诸实践。但这一估计没有明确定义，不同类型干预(例如，新药与新外科手术相比)之间的研究转换所需时间的差异也没有得到很好的确定。这些翻译延误或“时间滞后”的来源也不清楚，也不清楚它们是否总是令人不快。例如，新药在投入普遍使用之前进行安全性测试是很重要的。随着翻译空白模型的数量成倍增加(此类空白的定义也增加了)，在不同研究之间进行比较和推进研究领域变得越来越困难。我们的项目将提供一种促进这种比较的方法。我们项目的目标是开发一种新的方法来思考这些时间滞后，纳入一个过程标记模型，这是一种跟踪将研究转化为实践的不同里程碑之间所用时间的方法。我们新的案例研究方法应该能让我们更清楚地了解时间滞后的来源，无论它们是不是不可取的，以及不同类型的医疗干预是否不同。我们对将研究转化为实践的例子中的时间表的分析还将探索一系列利益相关者的观点，包括私营部门经常没有充分融入此类学术研究，以及从早期研究到在医疗保健领域成功实施的复杂过程中的一系列问题。我们将在心血管和精神健康研究中通过少量例子来试验该方法。如果该方法被证明是有效的，我们希望随后扩展这项研究，并对整个卫生研究系统的时间滞后进行更全面的分析。试图减少时间滞后和加快翻译过程的问题正受到英国和美国等国政策制定者的相当大的关注和投资。我们的前提是，在找到最有效的政策之前，我们需要改进方法来分析问题，并衡量时间滞后的程度。为了帮助更充分地了解这些进程，并为任何似乎适当的政策建议提供信息，我们还提议对现有的政策举措进行一次文件分析。最终，如果我们能够清楚地找出时间延迟的来源，以及它们可能受到政策的影响，我们希望我们的研究将允许研究的转换变得更快，这意味着患者更快地从新的研究发展中受益，提高患者护理的有效性和效率。此外，它最终可能会对制药和医疗器械公司带来相当大的好处，这些公司热衷于探索如何将研究更安全地更快地转化为医疗保健系统购买和使用的产品。具体地说，就英国的经济竞争力而言，被视为学术研究界可以与制药和医疗设备公司有效合作的国家对英国来说是相当有利的。最后，试图衡量医学研究的投资回报需要纳入对研究翻译所需时间的分析。如果我们能够改进分析时间差距的方法，并开发出一个更可靠的时间差距长度数据，那么这将对衡量研究与经济影响之间的联系，并加强对英国医学研究价值的估计做出重大贡献。

A major challenge in medical research is how best to ensure that research findings are effectively translated from 'bench to bedside', and are put into practice to benefit patients. Research suggests that at present in the UK it typically takes 17 years for new discoveries to be put into practice. But this estimate is not clearly defined and the difference in the time taken to translate research between different types of intervention (e.g. a new drug compared to a new surgical procedure) is not well established. The sources of these delays in translation, or 'time lags', are also unclear, as is whether they are always undesirable. It is, for example, important that new drugs are tested for safety before being put into general use.As the number of models of translation gaps multiplies (and the definitions of such gaps increases), it becomes increasingly difficult to make comparisons between different studies and advance the field of study. Our project would provide a way to facilitate such comparisons.The aim of our project is to develop a new approach to thinking about these time lags, incorporating a process marker model, which is a method that tracks the time taken between different milestones in the translation of research into practice. Our new case study approach should allow us to understand more clearly the sources of time lags, whether they are undesirable or not, and whether they differ between types of medical intervention. Our analysis of timelines in examples of research being translated into practice will also explore the perspectives of a range of stakeholders including the private sector, which is often inadequately incorporated into such academic studies, and a full range of issues in the complex pathways from early research to successful implementation in healthcare.We will trial the method with a small number of examples in cardiovascular and mental health research. If the method proves effective, we hope to then extend the study and conduct a fuller analysis of time lags across the health research system. The issue of attempting to reduce time lags and speed up the translational process is receiving considerable attention and investment from policymakers in countries such as the UK and the USA. It is our premise that we need improved methods to analyse the problems, and measure the extent of the time lags, before the most effective policies can be found. To help understand the processes more fully and inform any policy recommendations that seem appropriate we also propose to conduct a documentary analysis of the existing policy initiatives. Ultimately, if we can clearly identify the sources of time lags, and where they could be influenced by policy, we hope our study will allow the translation of research to become quicker, meaning patients benefit more quickly from new research developments, improving the effectiveness and efficiency of patient care. Furthermore, it could eventually be of considerable benefit to pharmaceutical and medical device companies who are keen to explore ways in which research could safely be translated more rapidly into products purchased and used by healthcare systems. Specifically in relation to the economic competitiveness of the UK it is of considerable advantage to the UK to be seen as a country in which the academic research community can collaborate efficiently with pharmaceutical and medical device companies.Finally, attempts to measure the return on investment in medical research need to incorporate an analysis of the time it takes for the research to be translated. If we can develop an improved way of analysing time gaps, and develop a more reliable figure for the length of the time lags, then that would make a major contribution to measuring the links between research and economic impacts and strengthening the estimates made of the value of UK medical research.