Low-key and to the point, endocrinologist Lars Berglund hardly seems a radical. Yet, as director of the UC Davis Clinical and Translational Science Center (CTSC), Berglund is at the forefront of what is shaping up as a transformational revolution in the way medical breakthroughs lead to medical therapies.
"We are seeking a fundamental change in the culture of academic institutions," Berglund says matter-of-factly.
UC Davis' CTSC is encouraging change in ways ranging from funding start-up research projects to providing better access to the analytical tools, such as an easily accessible clinical trial infrastructure or informatics assistance.
The engine for this transformation-in-the-making is the National Institutes of Health , which made UC Davis one of the first members of the Clinical and Translational Science Award consortium, now 38 research-institutions-strong. In 2012, when the program is fully implemented, approximately 60 institutions from across the country will be linked, supported by an annual budget of $500 million.
Patient, community focus
The goals of the consortium include:
For researchers, this translates into developing multidisciplinary collaborations within and between research centers; accessing sophisticated technologies and expertise; and receiving support with administrative and regulatory tasks.
This contrasts with the old way of doing things in which clinical researchers were typically only able to utilize the resources offered by their own departments.
"In the past, if you had a mentor who hadn't done an IRB (Institutional Review Board) approval in 15 years, you were pretty much on your own," said Nicholas Kenyon, an associate professor of pulmonary and critical care medicine and director of one of CTSC's new clinical research training programs for medical students and pre-doctoral candidates.
"Now, it is easier for new investigators to do clinical and translational research," Kenyon says. "I frequently get asked who one should turn to for advice, and now, I can refer researchers directly to various staff or faculty in the CTSC who are invested in doing this sort of thing. It has helped to foster collaboration and create an environment of success."
Indeed, research funding at UC Davis Health System has continued to expand rapidly despite flattening state and federal government research budgets. External research funding for UC Davis Health System has reached nearly $150 million, up from about $100 million just four years ago.
Established in the fall of 2006 with a $24.8 million NIH award, the UC Davis CTSC has established a leading role not only in Sacramento but also nationally to implement the NIH vision of bringing new therapies and treatments to patients sooner.
As part of the 38-institution consortium, UC Davis chairs half of the major steering committees and was instrumental in launching a new West Coast consortium to explore ways the its members can pool their resources to advance research.
For the national organization, Berglund co-chairs the influential oversight committee, which allows members and NIH staff to discuss initiatives and share experiences and best practices.
Sergio Aguilar-Gaxiola directs the center's community engagement efforts as wells as co-chairing the national community engagement steering committee. Frederick Meyers, who directs the research, education and training program at the UC Davis center, is also co-chairing a similar effort at the national level. And, Alice Tarantal is co-chair of the national translational steering committee, similar to what she oversees at the UC Davis center.
Test bed for new ideas
UC Davis also is taking the lead in organizing consortium members located in California, Oregon and Washington into a sub-group so they can seek ongoing collaborations. The regional organization has held two meetings that have now led to monthly discussions between informatics groups at UC Davis and Oregon Health & Sciences University; the identification of "core competencies" in research education; and the creation of a working group to address community-engagement issues.
Beyond these specific results is a more general payoff.
"While the West Coast consortium members are learning how to work together and take advantage of each other's resources, the group is also a wonderful test bed for new initiatives and ideas," Berglund says.
The regional group has drawn the attention of NIH officials.
"I am very impressed with the way UC Davis has helped to develop a West Coast Consortium to increase efficiency of translational research, especially through interactions with other institutions," says Barbara M. Alving, director of the National Center for Research Resources, the NIH unit in charge of the national consortium.
Alving also praises the UC Davis CTSC for promoting interactions between investigators of the medical school and in the California National Primate Research Center. The center, a federally funded biomedical research facility located on the Davis campus, is part of a network of eight NIH-sponsored primate research centers.
Alving emphasizes how the UC Davis CTSC has also reached out to the UC Davis Graduate Management School to develop courses that will be useful to investigators who want to learn how to move ideas and products into the marketplace.
Partnering with other campus units, often on workshops and symposiums to promote scientific collaboration, is one way the CTSC is furthering NIH goals to increase multidisciplinary research and community involvement in research projects.
Last year, for example, the CTSC matched grants with the UC Davis Cancer Center to support collaborative studies on inflammation. The cancer center and the CTSC solicited applications, received 14 proposals and funded four research projects. This was followed a few months later with a joint CTSC-cancer center workshop on common mechanisms of inflammation that attracted more than 200 faculty.
Funding innovative research
At another workshop earlier this year dubbed "Bridging the Causeway," event organizers announced the funding of several community-based research grants, ranging from a study about assessing physicians' counseling on diet and exercise to understanding the barriers to mental-health care for migrant farmworkers. The workshop was sponsored by the CTSC, the Center for Healthcare Policy and Research and the Center for Reducing Health Disparities.
Berglund says CTSC members have been working with faculty in the Department of Biomedical Engineering in the School of Engineering to come up with strategies for developing new diagnostic and therapeutic technologies to help those suffering from atherosclerotic cardiovascular disease.
And in response to the increasing number of soldiers returning from Iraq with traumatic brain injuries – a trend that has been felt sharply at the Sacramento-based Department of Veterans Affairs Northern California Health Care System – Berglund says the CTSC has been providing research funding to the neurology and psychiatry departments to jumpstart research to assess returning soldiers' injures.
CTSC has also supported 13 innovative studies that are aimed at improving research efficiency or identifying novel research methods, including:
In line with the CTSC's emphasis on bringing together scientists from different disciplines, most of the pilot grants have been collaborative in nature. Cristina Davis, an assistant professor of Mechanical and Aeronautical Engineering, used her 2007 pilot grant to work with Pulmonary and Critical Care Medicine physicians in developing a diagnostic device that can measure a host of compounds in exhaled breath to aid in identifying disease or bioterroism exposure, for instance.
Similarly, Mark Underwood, assistant professor of Pediatrics, used his 2007 pilot grant to collaborate with faculty from the departments of Medical Microbiology and Immunology, Viticulture and Enology and Chemistry to compare the effect of human milk and formula on premature infants in their ability to fight infection.
"We're aiming to give people the tools to be effective researchers and part of that is being able to work well with other researchers," explains Meyers, CTSC's education and training program head. "The traditional model of rugged individualists focused on their own molecule is a thing of the past."
Collaboration and meeting critical patient care needs are also the hallmarks of the education and training programs that Meyers oversees. The programs, aimed primarily at junior faculty in the early stages of a clinical research career, differ in a fundamental way from similar training programs elsewhere at UC Davis. While such programs tend to focus on a single discipline, like cardiovascular science or neuroscience, the CTSC training programs are multidisciplinary in nature – drawing scholars campuswide. To date, 48 researchers have participated in CTSC training programs and building new research teams to address specific health needs.
Work left to do
It seems clear that the UC Davis CTSC has made great strides in its less than two years of existence in funding novel research, providing a more streamlined research support system and in providing researchers with the training needed to conduct complex, multidisciplinary studies.
Yet, much remains to be done, Berglund says. He is particularly focused on addressing the critical arena of industry contracts and public-private partnerships, where CTSC officials have only just begun to take steps to shorten the timeline between research breakthroughs and drug therapies that benefit patients.
Still, Berglund expresses satisfaction with the progress so far.
"We've achieved what we have because we've built a great team."