The NIH Roadmap discusses two basic steps of translation. First, basic science research must be translated to humans (called T1 translation), and then translated into clinical practice (called T2 translation) (http://nihroadmap.nih.gov/). Additional analysis has demonstrated that this second phase of translation includes two separate steps: first knowledge from T1 translational studies must be translated to patients (T2), and then we must translate this knowledge into actual clinical practice (called T3 translation).
In T1 translation, basic scientific data must be first translated into animal models. These pre-human experiments typically require the collaboration of many scientists working in different research laboratories. Next, clinical researchers must assess the potential clinical applications in specific clinical conditions through controlled early-phase clinical trials in humans, followed by application more broadly through phase 3 trials. Once clinical applications have been proven through this T2 translation, clinicians must find ways to apply these findings to the daily care of patients (T3). Merely translating findings to patients with disease, however, is not enough. Moving scientific knowledge into the public sector and thereby changing people’s everyday lives to prevent or decrease the burden of disease represents yet an additional major challenge (called T4 translation).
Despite the obvious importance of T1 and T2 translation, without T3 and T4 translation we cannot bring the full benefits of medical research to individual patients and our communities. Merely knowing that an intervention can make people healthier is insufficient, we must also find ways to educate the general population and facilitate healthier lifestyles. GHUCCTS investigators span the full spectrum of T1 through T4 research as the embodiment of our commitment to improve the health of our communities, both patients with diseases as well as the healthy public.
adapted from: Kon AA. The Clinical and Translational Science Award (CTSA) Consortium and the Translational Research Model. Am J Bioeth. 8(3):58–W3, 2008.