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Robert E. Ratner, MD, FACP, FACE

March 21, 2012

Dr. Robert E. Ratner is Professor of Medicine at Georgetown University Medical School and Senior Research Scientist at the MedStar Health Research Institute in metropolitan Washington, DC.  He recently completed a sabbatical as a Robert Wood Johnson Foundation Health Policy Fellow, having served as the study director for the IOM Comparative Effectiveness Research Priorities Committee, and a program examiner for health reform in the Health Division of the U.S. Office of Management and Budget.

Why is it important to have diversity in medical research? What does diversity contribute to your research?

Diversity in research can describe either the collaborative group undertaking the research or the population being studied.  In both circumstances, the research is richer and more generalizable as a result of diversity.  My own research in diabetes has been enormously enriched by the diversity of colleagues with whom I have collaborated.  Incorporation of nutritionists, nurse educators and behavioralists has been critical to our work in diabetes prevention and therapeutics.  My work with obstetricians was imperative for our efforts in diabetes and pregnancy and cardiologists have contributed enormously to my understanding and work in cardiovascular disease and diabetes.  Working in Washington, DC for the last 29 years has opened my eyes to the disparities in both disease epidemiology as well as health care delivery.  Working with the community to bring screening, prevention and care to previously under-served populations enriches my research and provides new insight into new questions to be addressed.

How does having a diverse background in different aspects of research enhance discovery? 

Collaborating with others from different scientific backgrounds expands the range of questions to be asked and techniques available to address them.  For example, our work in diabetes and cardiovascular disease could not have been undertaken without the input and support of epidemiologists, nuclear medicine, echocardiographers, and invasive cardiologists.  As a result, we have been able to publish work from the SANDS Study and DIAD in JAMA, and the APPROACH study in Circulation.  Many different areas of medical and scientific expertise came together for the development and execution of the Diabetes Prevention Program, leading to major publications in the New England Journal of Medicine, Lancet, Annals of Internal Medicine, Diabetes, and Diabetes Care.  Bringing together diverse perspectives provides more complete answers to the pressing research questions we address.

How do your research program and your institution contribute to the diversity of GHUCCTS?

Our research program includes specialists in nutrition, diabetes education, epidemiology, health economics and health policy, cardiology, and obstetrics.  Our focus on diabetes has been strongly influenced by the disproportionate impact of the disease on the African American population in Washington, DC.  The Diabetes Prevention Program and other diabetes therapeutic studies undertaken in our CRU have routinely provided the African American representation to answer questions of disparity, generalizability, and pharmacogenomics in large scale clinical trials.  Our commitment to multi-specialty collaboration is now extended to multi-institutional collaboration within GHUCCTS.

How does having diversity in research benefit the community, both directly and indirectly?

Many of our studies (such as the Diabetes Prevention Program) are community-based interventions.  We provide general education, public awareness, and screening for disease.  Our clinical research interventions provide direct care and education to the participants, with access to services not always available in the community.  As a result, we hope to increase the recognition of diabetes as a serious disease; but one which can be prevented if high risk individuals are identified, effectively treated when caught early, and avoidance of complications such as cardiovascular disease.