President Barack Obama talks with Evan Jackson, 10, Alec Jackson, 8, and Caleb Robinson, 8, from McDonough, Ga., while looking at exhibits at the White House Science Fair in the State Dining Room, April 22, 2013. The sports-loving grade-schoolers create a new product concept to keep athletes cool to help players maintain safe body temperatures on the field. (Official White House Photo by Chuck Kennedy)

Last year, we visited a number of psychology professors at office hours. We asked many of them how they saw their research influencing policy, or having a tangible effect on people’s lives.  They explained that it might prove useful to understand better how peoples’ minds work.  We pressed them a bit further, asking if they envisioned any of the research questions they explored informing government policies or mental health treatments. They responded that they didn’t really envision their research informing government policies or mental health treatments.  They explore the questions they do because they are the questions that keep them up at night.  They find their research questions intellectually fascinating, endlessly engaging: These are the questions that drive them.

We admired these professors’ passion and purpose. They embodied the fascination, curiosity, and motivation that one would expect from a successful professor. They viewed academia as the way to explore the mysteries of the human experience. With the resources and the freedom that academia offers, these professors were equipped to tackle the questions that they found most interesting.

However, we were disappointed with their disregard for the influence of their research outside of the Ivory Tower. They didn’t have a satisfying answer to our question about how their research could influence policy or clinical care. They didn’t see their careers as researchers as careers in service of the public good.

This separation between research and public service is problematic for several reasons. First, we believe that all individuals have the responsibility to alleviate unnecessary suffering.  Second, research is very often funded by public organizations such as the National Institute of Health. Therefore, taxpayers deserve research that improves their lives.  Third, academics are uniquely poised to conduct this research.  They have unique access to training, labs, research subjects, instruments, and funding. Finally, their prestige affords them remarkable influence.  If a Harvard scientist and an average person present the same theory, the Harvard scientist is much more likely to be taken seriously.  

For these reasons, researchers have a moral responsibility to do research in service of the public.  Given that there are finite resources devoted to research, research that promotes the public interest should be prioritized. There are three ways of conducting research to fulfill this moral responsibility.  First, basic science research can help us understand mechanisms and theories that inform applied research. When deciding which basic research to pursue, we believe scientists should prioritize basic research with the greatest expected value for the public. Second, knowledge of mechanisms and theories can be used to design, test, and modify interventions in lab-based research.  Third, these new interventions can be tested in real-world settings on target populations.  We call this third step translational research: bringing interventions to those it is intended to benefit.  

For example, insulin treatment for diabetes was developed with these three steps.  First, scientists conducted basic-science research  to determine that lack of insulin is related to diabetic symptoms.  Then, they tested injectable insulin on diabetic lab animals in applied lab-based research.  Finally, translation research was conducted: injectable insulin was tested on human patients in clinical settings. Following these trials, insulin became widely prescribed to diabetic patients.

When scientists consider which research questions to pursue, grant organizations consider which research to fund, and students consider which labs to join, we believe they should prioritize projects that contribute to translational research. These could be basic science projects or lab-based trials, but the ultimate goal should be to contribute to translational research. Basic science and lab-based research are immensely valuable when they contribute to translational projects that end up affecting people in the real world.

At first glance, it may seem difficult to predict which research projects will result in the highest benefits to society. While it is impossible to perfectly predict, we believe that it is possible and desirable to predict with some accuracy. For instance, the European Research Council has begun evaluating research projects based on their “impact on the world outside science.”

Translational Research at Harvard

Students interested in translational research may be curious to know what translational research actually looks like. Some clinical psychology labs provide a useful example. These labs develop new ways of treating mental illness on patients in clinics, schools, and other “real world” community settings, rather than in university labs. For instance, one lab at Harvard is currently doing a study testing the effectiveness of mental health treatments in two school districts. In this study, school counselors are delivering the treatment, and participants are children who were referred for treatment. Surprisingly, the approach of this lab is quite different from most other labs.  

Treatment research in clinical psychology has typically taken place in lab settings. In these research studies, members of the lab usually deliver therapy to participants who were recruited by advertisements. Often, these participants must meet certain criteria in order to qualify (i.e. participants in a lab research study on depression may exclude people with both depression and an anxiety disorder).  These controlled lab conditions differ quite a bit from “real world” therapeutic settings. In real world settings, patients very often have multiple disorders, and clinicians vary in their knowledge of treatments. In other words, treatment in the real world is affected by many more variables than treatment in the lab.  This is why treatments that are tested in lab settings are often less effective when they are used in schools and community clinics. Performing research in real-world contexts can therefore result in more accurate and usable findings. While theories and discoveries made in lab settings may help us determine what to do in the real world, it is important to test those ideas outside of lab settings.

The Future of Translational Research

How can we incentivize more translational research? Perhaps the most important way of ensuring that translational research is prioritized is to train students to value and understand translational research. In this way, labs that perform translational research provide more than just their research—they also provide mentorship and inspiration to a new generation of scholars.

It is especially valuable for students to have role models in academia that are serving the public interest. To many, a path in research implies a remote life in the Ivory Tower. As a result, many students interested in translational research may view academia as too removed from the public good and instead become clinicians.

Surely, it is valuable to have intelligent translational minds in these direct service roles; however, clinicians need to rely on interventions developed by research scientists in order to most effectively help patients. Consider the case of Scared Straight programs. In these interventions, youth visit prison, observe the living conditions, and interact with inmates. Many activists believed that these programs deter youth from violating the law. However, research suggests that these programs are not effective—in fact, they may even make youth more likely to break the law.

Translational research allows for the scientific evaluation of interventions—even ones that intuitively seem effective. There are plenty of examples in which reasonable intuitions fail to produce an effective intervention. Translational research separates the effective strategies from the ineffective ones. The wellbeing of a school district depends not only on the work of its teachers and administrators but also on the work of educational researchers. The impact of a hospital depends not only on the work of its doctors but also on the work of biomedical researchers. Though the effect of research is often less direct than the effect of other forms of service, translational research bridges the gap between academia and public service.

 

Image Credit: https://obamawhitehouse.archives.gov

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