medicine has made impact and have come to be accepted (Dai, et al., 2013) as a
global medical strategy for improving Medicare such that, funding of
translational medicine globally has increased, it is treated with priority and
many institutes for translational studies have been established, (Zhang, 2012).
Demonstrating this critical significance of translational medicine to modern
medical practice is the emphasis by the World Medical Association (WMA Ethics Manual, 2009), that ‘physicians must know how to interpret
research results and apply them to patients’.
as noted by Zerhouni, (2007) and Qian et al., (2012), a lot remains to be
understood and lessons need to be learned on the best strategies for translational
medicine which may not be unconnected with observed issues of clinical research
bottlenecks. Mankoff, et al., (2004), had earlier identified “three major
obstacles to effective translational medicine”. The first two revolves around
the subject of clinical research; – “the challenge of translating basic science
discoveries into clinical studies”, and “the translation of clinical studies
into medical practice and health care policy”. This second issues hinges on the
core challenges of the practical conduct of clinical research. Sung, et al.,
(2003) opined that the two
“translational blocks can be removed only by the collaborative efforts of
multiple system stakeholders”
Essential for research translation is data
generated from clinical research. Clinical trials operations require
cooperation among a diverse group of stakeholders including research sponsors
(industry, academia, government, non-profit organizations, and patient
advocates), clinical investigators, patients, funders, physicians, and regulators.
This was aptly captured by Dai,
et al., (2013), who noted that “enormous collaborative and multidisciplinary work is
required prior to when the results of scientific research can be translated
into effective clinical practice”. Each stakeholder offers
a different set of tools to support the essential components of a clinical
trial. These resources form the infrastructure that currently supports clinical
et al., 2010). Time, money, personnel, materials (e.g., medical
supplies), support systems (ICT as well as manpower), and a clear plan for
completing the necessary steps in a trial are all part of the clinical research
Significant time, energy, and money from the
different collaborators are spent on bringing the disparate resources together.
Because these resources are not streamlined, clinical trials infrastructure
pose challenges to investigators working on new research questions and most
times must start afresh without drawing on existing resources. This imminent
lack of harmony and disparate clinical research resources imposes bottlenecks
that constitute impediments on the planning, execution and outcome of research
which by implication either slow down or prevent translation outright.
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