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Overview

Overview


The Translational Spectrum

Translational research involves moving knowledge from basic science to proof-of-concept studies (T1),  clinical trials  (T2), medical practice (T3) and population health (T4). As shown in the table below, CTSI research has impacted health across the translational spectrum. We prioritize groups that  historically have been excluded from research, including older adults, children, and populations experiencing health disparities.


Phase Population Project and Impact

T1

Children

Supported by a CTSI Core Voucher Award, April Pyle, PhD, created functional skeletal muscle cells and used them in animal models of Duchene muscular dystrophy to restore dystrophin, the protein missing in the muscle-wasting disease that affects boys and young men.

Outcome. Her successful research was published in Nature Cell Biology [1].

T2

Children

Related imageAssisted by the CTSI’s study activation team in the CTRC, Noah Federman, MD, led UCLA’s participation in the multisite clinical trial of larotrectinib in children with bone and soft tissue sarcoma. 

Outcome. Results published in the NEJM led to FDA approval of the drug in children and adults with cancers that have an NTRK gene fusion, the second tissue-agnostic drug ever approved [2].

T3

Disparities and Older Adults

Work by KL2 scholar John Mafi, MD, demonstrated that a multipronged nurse-led, quality-improvement initiative at a Los Angeles safety-net hospital was associated with sustained reductions in low-value preoperative testing for cataract surgery compared with a control safety-net site. 

Outcome. This work led to county-wide implementation and to an R01 to incorporate behavioral economics approaches in partnership with UCLA Anderson School of Management faculty [3].

T3

Disparities

Image result for ucla intensive care photosWith funding from a CTSI Safety-Net Innovation Award, Dong Chang, MD of Harbor, developed an intervention that brought families and patients into the decision-making process to reduce non-beneficial ICU care. 

Outcome. Based on these results, Dr. Chang and his team received a foundation award to conduct a wider study involving additional hospitals across the county [4].

T4

Older Adults

As a KL2 Scholar, Joshua Pevnick, MD, of Cedars implemented a method to obtain accurate medication history for every high-risk patient upon admission. 

Outcome. His research contributed to passage of California Senate Bill 1254, which requires hospital pharmacy staff to obtain medication histories upon admission, enhancing patient safety [5, 6].

References

  1. Hicks MR, Hiserodt J, Paras K, Fujiwara W, Eskin A, et al. (2018) ERBB3 and NGFR mark a distinct skeletal muscle progenitor cell in human development and hPSCs. Nat Cell Biol, 20(1):46-57. Epub date: 2017/12/20 PMC5962356.
  2. Drilon A, Laetsch TW, Kummar S, DuBois SG, Lassen UN, et al. (2018) Efficacy of larotrectinib in TRK fusion-positive cancers in adults and children. N Engl J Med, 378(8):731-739. Epub date: 2018/02/22 PMC5857389.
  3. Mafi JN, Godoy-Travieso P, Wei E, Anders M, Amaya R, et al. (2019) Evaluation of an intervention to reduce low-value preoperative care for patients undergoing cataract surgery at a safety-net health system. JAMA Intern Med, 179(5):648-657. Epub date: 2019/03/26 PMC6503569.
  4. Chang D, Parrish J, Kamangar N, Liebler J, Lee M, et al. (2019) Time-limited trials among critically ill patients with advanced medical illnesses to reduce nonbeneficial intensive care unit treatments: Protocol for a multicenter quality improvement study. JMIR Res Protoc, 8(11):e16301. Epub date: 2019/11/26 PMC6902129.
  5. Pevnick JM, Nguyen C, Jackevicius CA, Palmer KA, Shane R, et al. (2018) Improving admission medication reconciliation with pharmacists or pharmacy technicians in the emergency department: a randomised controlled trial. BMJ Qual Saf, 27(7):512-520. Epub date: 2017/10/08 PMC5912995.
  6. Martinez C (2018) Pharmacy Chief’s Passion for Medication Safety Leads to New Law. https://www.cedars-sinai.org/newsroom/pharmacy-chiefs-passion-for-medication-safety-leads-to-new-law/. Accessed April 10, 2020.