Editorials |
From the National Heart, Lung, and Blood Institute, Bethesda, Md.
Correspondence to Elizabeth G. Nabel, MD, National Heart, Lung, and Blood Institute, 31 Center Dr., Room 5A48, Bethesda, MD 20892. E-mail nabele{at}nih.gov
| Introduction |
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| The Planning Process |
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In October 2006, a Level Two meeting brought together members of the National Heart, Lung, and Blood Advisory Council, chairpersons of the Level One meetings, and other leaders from the research community. Their task was to review the reports of the Level One meetings, synthesize and prioritize objectives and strategies, determine methods for measuring progress toward achieving objectives, and recommend approaches for fostering development of the research workforce.
Level Three, which was completed in February 2007, entailed development of a draft plan to reflect the vision of the research community. Comments on the draft were widely solicited from the Institutes diverse stakeholders and incorporated, as appropriate, into the final version.
| The Content of the Plan |
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The plan identifies a number of basic research areas of focus with the intent of delineating normal and pathological biological mechanisms and exploiting the emerging understanding of these mechanisms to identify biomarkers of disease. Such biomarkers—broadly defined as measurable indicators of genotype, biological or pathological processes, or responses to therapeutic intervention—will facilitate identification of disease subtypes and point the way toward new molecular targets for prevention, diagnosis, and treatment.
The clinical and translational research goal of the plan emphasizes transmission of knowledge between basic and clinical research so that findings in one arena rapidly inform and stimulate research in the other. More precise methods of risk-stratification and diagnosis are expected to arise from application of new approaches (eg, noninvasive imaging, biomarkers) from basic science laboratories. A critical challenge will be to develop personalized preventive and therapeutic regimens based on genetic makeup in combination with developmental and environmental exposures. Insights are already emerging, but robust and efficient means of validating both individualized and population-based treatments will be needed to establish an evidence base to guide medical practice.
The plan acknowledges the need to enhance understanding of the processes involved in translating research into practice and to use that understanding to enable improvements in public health and stimulate further scientific discovery. It places particular emphasis on conducting research in primary prevention and identifying interventions that work in the practice communities that will ultimately constitute the targets for translation and education. As well, continued development and evaluation of new approaches to communicate research advances to the public is an important priority.
| Next Steps |
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As the challenges identified in the plan are met and as new ones emerge, the NHLBI will identify and embrace new strategies. The Institute also will continue to look to its Advisory Council and to the larger research community for guidance to ensure that these strategies are updated as needed to reflect the rapidly changing environments of research and public health issues.
The plan is ambitious and far-reaching, but we have every confidence in its ultimate success. We hope the community will join us in the important work of achieving its vision.
| Acknowledgments |
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None.
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