A successful translational research team is focused on specific questions and problems. The goal: To understand more about a particular disease process and obtain an improved outcome for the affected patients.
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“The team’s research program is driven by both the questions they select as a top priority, as well as the availability of the specific technical skills required to answer those questions,” says Lauren M. Pachman, MD, head of Cure JM Center of Excellence in Juvenile Myositis Research at the Stanley Manne Children’s Research Center of Chicago, and the Ann and Robert H. Lurie Children’s Hospital, Northwestern University, Feinberg School of Medicine, Chicago, Ill. Dr. Pachman has led various translational research teams for more than 40 years.
The team Dr. Pachman now leads was created to study clinical and research aspects of the most common pediatric inflammatory myopathy, juvenile dermatomyositis—a rare disease. The team includes two pediatric rheumatologists who see patients and contribute to the research, a project coordinator, a database manager, an administrator and data entry personnel. A pediatric research nurse, who works with the children, may also be involved. The laboratory side of the center is staffed by a laboratory director, who oversees one or more technicians, and a post-doctoral medical fellow, who is currently being trained in pediatric allergy-immunology and pediatric rheumatology, and finally, an experienced and skilled biostatistician.
“Each individual has excellent interpersonal and communication skills to identify problems and their solutions—in addition to their specific technical expertise,” Dr. Pachman says. “They have earned the trust of the other team members. Each person understands what they are responsible for and the type of data that needs to be generated to solve the problem at hand.”
Staying on target: Dr. Pachman holds weekly meetings with the entire team. Each team member is responsible for discussing the progress and problems generated by one or more agenda items. Between meetings, Dr. Pachman checks in with each team member at least twice weekly to see if technical or logistical problems have arisen or if new data have been generated.
The challenges are multiple. The major problem for clinicians is having enough uninterrupted time unrelated to patient care to think about the specific experimental problem and generate enough funding to address the specific question at hand.
Creating a Team
When interviewing potential team members, Dr. Pachman reviews the current list of unanswered research questions with the applicant trainee to determine which of these specific clinical and/or laboratory based questions appeals to them.
If the applicant is a fellow with a year or more to spend on the project, they may bring a specific research topic with them. “In that case, we assess if we have the physical and financial resources that the research approach demands,” she says. “If not, we work together to identify sources of funding and help them with the application process.”
Another important consideration: Does the applicant, especially the rheumatology fellow, have sufficient time to devote to the research project? “Often, we will help them finish the project after they have left our rotation,” Dr. Pachman says. “This [approach] enables them to retain first or second authorship, and still participate in the manuscript preparation process.”
Leading a Team
The person leading a research team should have imagination, empathy, fairness, patience and rigor. Dr. Pachman says, “Leaders share the excitement of a successful experiment and the disappointment when something does not work as expected.”
Two constant challenges of leading a team include maintaining funding and securing protected time for research.
“With the current increased stresses on National Institutes of Health funding as a reliable source, we must tap other organizations,” she says. Additionally, as hospital funding becomes less secure, physician researchers must often cover the salary related to their time spent in research through increased delivery of service (i.e., patient care) either at clinics or on the wards. Other modalities must cover the increasing cost of supplies and modern equipment. An advantage of translational research is that the clinical investigator can sometimes go back to their patient base and encourage philanthropy.
Leading a translational research team differs from other types of research teams. In translational research, the question being explored always looms in the background. Rather than simply asking, “Does A affect the behavior of B?” researchers ask: “How will this work to improve the patient experience or outcome?”
“A better outcome for the child [or patient] that is derived from the new knowledge gained is very satisfying for everyone concerned,” Dr. Pachman concludes.
Karen Appold is a medical writer in Pennsylvania.