Yesterday, AcademyHealth, Research!America, the American Heart Association, and WomenHeart: The National Coalition for Women with Heart Disease joined forces to co-host the congressional briefing “From Discovery to Delivery: Research at Work Against Heart Disease.” The event was standing room only, with approximately 80 attendees, roughly 30 percent of which were congressional staff. There were also representatives from the National Center for Health Statistics, the National Heart Lung and Blood Institute, and the Agency for Healthcare Research and Quality.
Dr. Lisa Simpson, President and CEO of AcademyHealth, opened the briefing by explaining that although health research is being funded across the federal government, each agency has a unique role and therefore funds a certain, yet critically important type of research. This briefing illustrated how the different types of federally-funded research work across a continuum, each complementary and equally necessary to improve and transform health and health care. Speakers did this by walking attendees along the research continuum using the example of heart disease--the leading cause of death in the United States for both men and women:
Basic Research: The research that increases our knowledge about how organisms work and what causes disease.
Research begins at the “discovery” phase, where investigators are attempting to find out how the body works, which genes are responsible for disease, and how positive forces in one section of the body can be transferred to tackle conditions in other areas of the body. Dr. Shobha Ghosh, Ph.D., associate chair of research at Virginia Commonwealth University, described her work looking at the genes responsible for removing cholesterol from the body, the extensive research process required to identify it, and subsequent efforts to utilize it to potentially help cure heart disease.
Clinical Research: The research that determines how to prevent and treat that disease in people.
In research’s progression to reaching and helping patients, the clinical research phase is also critical. This type of research looks at which treatments are safe and effective for treating areas such as hypertension and hypercholesterolemia. Dr. Andrew Zalewski, M.D., vice president and head of unit physician in the Cardiometabolic Therapy Area at GlaxoSmithKline, represented this perspective and spent his presentation identifying three areas where he sees potential for collaboration across the research disciplines: 1) Increasing the probability of success in human genetics, which act as predictors of disease; 2) Continuing in efforts to advance the idea of ‘precision medicine’ and going farther to develop drugs that are truly effective; and 3) Streamlining the framework for more responsible and effective clinical trials.
Population-based Research: The research that addresses population health through non-medical means in communities where people live, work, learn, and play.
Efforts in this area aim to address and prevent injury, illness, and disease through non-medical means, including helping identify strategies to reduce trans fats in food and advancing tobacco control measures to reduce smoking.
Health Services and Translational Research: The research that determines how best to deploy the treatments and interventions in hand and the research that studies how best to move evidence across the continuum, promoting a faster uptake of the credible evidence that can improve health and health care, respectively.
Dr. Harry Selker, M.D., M.S.P.H., Dean of Tufts University Clinical and Translational Science Institute, made the case for this research, providing examples of how his work has helped and can continue to transform health care. For instance, his cardiac 'predictive instruments'--mathematical models that provide clinicians with predictions of key outcomes for real-time use in the clinical setting--assist doctors in determining which patients need to be sent to the catheterization (cath) lab for immediate treatment and which can wait. In this way, health services research, he said, can help us get treatments and interventions to the right patients at the right time. Translational research is about the impact on patient health; it spans research areas and connects biomedical and clinical studies to the patients.
Putting It All Together: The Patient Perspective
Denise Sullivan, a WomenHeart champion and heart disease survivor, brought the work of these researchers to life by putting a face on heart disease. Sullivan, who had family history with heart disease and experienced its signs and symptoms, said she denied them until hearing she would be a grandmother. After that, “everything changed.” For her, her heart disease was a constant reminder of the importance of modern technologies, research advancements, and the need for continued federal investments in this work; “The research makes a difference, and it gives us life.” She urged the standing room only crowd to “go out there, talk to who you need to talk to, and make sure this research is there to help my children and my grandchildren.”
To download the audio of this briefing, "From Discovery to Delivery: Research at Work Against Heart Disease", visit: http://bit.ly/1HXEBO6.