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Commentary in Neurology |

Translational Medicine in Neurology The Time Is Right

Sandra L. Helmers, MD, MPH; Victoria L. Phillips, DPhil; Gregory J. Esper, MD, MBA
Arch Neurol. 2010;67(10):1263-1266. doi:10.1001/archneurol.2010.253.
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Physicians are confronting the perfect storm. With a shift from an acute to a chronic disease burden, inundation of scientific data and innovations, and an unsustainable rise in health care spending, we are now tasked with answering the questions: “What works best for our patients, and when and how do we provide it?” Prospective, double-blind, randomized controlled trials (RCTs) assess the safety and efficacy of treatments and can lead to innovations in patient care. However, because of constraints in study design, RCT results do not always apply to general clinical populations. In addition, RCTs do not provide information on the cost-effectiveness of treatments nor on their sustainability in the health care arena. Translational medicine describes a multiphase process by which basic scientific discoveries are ultimately incorporated into clinical care, given differing practice patterns, funding streams for treatment, and patient preferences. The practice of neurology would be well served by creating applicable methods and incorporating more applied clinical research and comparative effectiveness.

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Figure. Phases of translational medicine, with the goal of improved health care decision making and improved health of the individual and the population.

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