June 6, 2018: Translating Translation
NCATS is unique at NIH in that the name in the Center’s mission — “translation” — has a firmly established meaning that is generally associated with languages, not biomedical research. By contrast, other NIH components are named for widely known medical problems, such as cancer, diabetes and stroke. NCATS’ outreach and education efforts are therefore especially complex. First, we must define what “translation” means as a biomedical research term. Second, we must convey why it matters. And third, we must explain what NCATS is doing to improve it.
To understand NCATS’ definitional challenge, imagine for a moment that neither you nor anyone you know, including your scientist and physician friends, had ever heard of cancer. But you knew it to be an enormous and deadly problem, and you were working hard to find a cure for it. You would have a difficult time garnering interest in your work until your colleagues understood what “cancer” was. Substitute “translation” for “cancer” and you can better understand NCATS’ challenge as well as its potential.
To help bridge this gap, I recently published a brief about three related terms — translation, translational research and translational science — in Nature Reviews Drug Discovery. I hope you will take a look at this freely available commentary and send me feedback.
“Translation” is firmly established as meaning the conversion of a message from one language into another. Biomedical translation, by analogy, is the process of converting a scientific or clinical observation into an intervention (e.g., drug, device, surgical procedure, behavioral change) that is shown to improve health.
Scientific translation is an exceedingly complicated process that involves dozens of steps. (See our Drug Discovery, Development and Deployment (4DM) Maps for a glimpse of just how complicated translation can be.) Imagine the child’s game of “telephone,” in which a message is translated into one person’s language, and then another, and so on a dozen or more times. The likelihood that the original meaning of the message would be successfully delivered in the final person’s language would be very small. Welcome to the world of biomedical translation!
The definitions of “translational research” and “translational science” follow from this understanding of the meaning of translation. Translational research attempts to move a particular project across one step of the translational process. In our telephone game analogy, translational research would correspond to the attempt to accurately convert a message from one language to another language (e.g., English to Chinese).
By contrast, translational science is the quest to understand how the translational process works, both at each step and as an integrated whole, so that we can improve the process to work faster and more successfully. In our telephone game, this would correspond to the study of what languages have in common, why individual translational steps fail, how to make those steps more reliable and whether it is possible to skip certain steps altogether. Why do so many drugs that are safe and effective in animals turn out to be toxic in humans? How could lab tests give better, more accurate answers about whether a new drug will work? How could clinical trials in humans be conducted more efficiently and safely? These are some of the translational science questions NCATS is trying to answer.
Understanding these definitions leads to rethinking the fundamental biomedical challenge of our era: how to deliver on the promise of science for patients in need. I will explore this reconceptualization, and its implications for NCATS, in upcoming messages. Stay tuned!
Christopher P. Austin, M.D.
National Center for Advancing Translational Sciences