Letter from the Dean

Dean Philip A. Pizzo, MD

Dean Philip A. Pizzo, M.D.

Dear Readers,

During the past year, we have reaffirmed the mission of Stanford University School of Medicine to be a premier research-intensive medical school that improves health through leadership and collaborative discoveries and innovations in patient care, education and research. One of the most important overarching themes that will enable us to achieve our mission is a renewed focus on translational medicine that embraces research and education as a means of improving patient care.

But what is translational medicine? In academic medicine, the term has become widely used and has a variety of interpretations and meanings among or even within academic medical centers. Let us explore them.

From my perspective, translational medicine can have both a narrow as well as a more general definition. Perhaps the most specific definition is "bench-to-bedside" research wherein a basic laboratory discovery becomes applicable to the diagnosis, treatment or prevention of a specific disease and is brought forth by either a physician-scientist who works at the interface between the research laboratory and patient care or by a team of basic and clinical science investigators.

Though translational research often focuses initially on a small number of patients, the impact of such patient-oriented clinical research can have sweeping effects on the practice of medicine. At Stanford, numerous examples of such translational research and medicine have arisen during the past years. And I have personally witnessed the impact of translational research during my own work in pediatric oncology, infectious complications in immunocompromised hosts and pediatric AIDS. These experiences have underscored the power of translational research in changing the outcome of serious diseases.

Translational medicine may also refer to the wider spectrum of patient-oriented research that embraces innovations in technology and biomedical devices as well as the study of new therapies in clinical trials. It also includes epidemiological and health-outcomes research and behavioral studies that can be brought to the bedside or ambulatory setting.

In the absence of translational and patient-oriented clinical research, the delivery of medical care would remain stagnant and uninformed by the tremendous progress now taking place in biomedical science. Thus, translational medicine represents a unique aspect of academic medical centers and teaching hospitals – the prospect of improving current health care through state-of-the-art translational research and medicine.

While translational research is critical to the future of Stanford medicine, our overall research agenda must be much broader and deeper. Current translational research is built on the foundations of fundamental basic research, much of which is undirected and without immediate clinical impact. Indeed, much of today's translational medicine is built on basic research investigations begun years or decades ago.

Accordingly, supporting basic research is critical since it is often not possible to predict which of today's extraordinary ideas in basic science will lead to clinical applications in the future. Thus, a solid basic research program is vital for translational medicine to flourish. Thankfully Stanford's program in fundamental research is very strong.

Supporting basic research is critical since it is often not possible to predict which of today's extraordinary ideas in basic science will lead to clinical applications in the future.

Stanford excels at fostering basic research and must now strive to excel at supporting translational research. At a minimum, this means enhancing interaction between basic and clinical scientists as well as creating an infrastructure – both administrative and physical – that facilitates and supports translational research. To that end, during the past year I appointed a Task Force on Clinical Research led by Dr. Charles Prober, professor of pediatrics and of microbiology and immunology and scientific director of the Glaser Pediatric Research Network. This task force has helped elucidate the key components needed to make our clinical research programs as robust as possible at Stanford and to better align them with public and private foundations, resources and organizations.

Collaboration is key

In addition to building the infrastructure to support clinical and translational research, we are seeking ways to encourage collaborations throughout the medical center. Clinical and basic science departments have responded with creative and supportive programs. For example, the Department of Medicine, led by Dr. Judy Swain, has joined with investigators at the Beckman Center, led by Dr. Lucy Shapiro, to support and fund basic and clinical science investigators who will collaborate on translational research projects. The Children's Health Initiative through the Lucile Packard Foundation for Children's Health, under the leadership of Dr. Alan Krensky, has also provided support for translational research in pediatrics.

We are also working at the broader organizational level to develop institutes that will bring together basic and clinical scientists to address areas of translational medicine. During the next couple of years we envision that these will take on specific themes. Possibilities include institutes devoted to cancer and stem cell biology, infection and immunity, neurosciences, and cardiovascular disease. We hope that such programs will foster communication and collaboration between our scientific and patient-care communities and, above all, generate knowledge that will improve the lives of adults and children.

I also believe that the future success of translational medicine will be more readily achieved by educating and training medical and graduate students about the important interface that links medicine and science. Indeed it is my hope that the students we teach today will bring forth the translational research discoveries of tomorrow.

To fulfill our mission of improving health through leadership and collaborative discoveries and innovations that improve patient care, education and research, we believe that translational research and medicine provide an overarching umbrella. Further, we believe that a focus on translational medicine will play an important role in further distinguishing Stanford as a premier research-intensive School of Medicine.

Philip Pizzo, MD
Dean, Stanford University School of Medicine

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