Knowledge Translation & Translational Research
Are They One & The Same?
In the past, as a graduate student studying the molecular biology of cardiac cells, I had my own perception of ‘knowledge translation’ (KT). I thought it was just about taking a potential molecular target for treating a disease (like a gene or a protein) to screening for drugs that might change the way the molecule works, or marketing the molecule as a potential marker for a certain disease. As it turns out, I wasn’t entirely wrong. What I thought was KT is more commonly referred to as ‘translational research’ (or knowledge transfer, or tech transfer, or one of many other terms used to describe moving basic research to the clinical realm). Once I started learning about KT theory and practice, and how it can impact healthcare and policy, I became utterly confounded as to what the difference between these two terms is.
I did some digging to try and tease out the conceptual differences, in the hopes of better understanding where basic/discovery research (like what I had been working on) fits into the whole spectrum of ‘translation’ in health sciences — and whether it ‘fits’ into the concept of KT at all. One way it’s been conceptualized (and divided) is the idea of ‘death valleys’ in health research — that there are two major gaps, or valleys; one between basic and clinical research, and another between clinical research and healthcare practice. Framed in this way, translational research ‘bridges’ the first gap, and knowledge translation addresses the second gap. But are the concepts really all that different? Isn’t the end goal the same — to improve health and healthcare with evidence?
CIHR defines knowledge translation (KT) as “a dynamic and iterative process that includes synthesis, dissemination, exchange, and ethically-sound application of knowledge to improve the health of Canadians, provide more effective health services and products and strengthen the health care system”. The National Institute of Health’s National Centre for Advancing Translational Science (NCATS) defines translation as “the process of turning observations in the laboratory, clinic and community into interventions that improve the health of individuals and the public — from diagnostics and therapeutics to medical procedures and behavioral changes”. Wait a sec — that sounds a lot like CIHR’s definition of KT. The only difference seems to be that it also takes into account the laboratory, where basic research happens (also known as ‘the bench’).
Maybe the two aren’t really different at all, and so I came to the conclusion that they are in fact, the same idea, applied to different contexts (and with vastly different degrees of separation from their end-users). Looking at the Knowledge-to-Action Framework, a practical framework for putting KT into practice that we use all the time at CHI, basic and discovery research most obviously fits into the “knowledge creation” part of the cycle — specifically the “knowledge inquiry” phase. This makes sense — if translational research involves getting a molecular target from cells to animals to clinical trials, this still doesn’t move out of the knowledge inquiry phase — but that doesn’t mean it’s not moving. And it does indeed fit within the concept of KT.
I found this to be a useful way to conceptualize translational research and align it with my new found (though limited) understanding of knowledge translation. It’s still important to note that, although basic research may not make its way directly to the action cycle, there’s still value in considering how it can be translated — be it knowledge translation, or translational research, or whatever other term you might prefer. Doing research without consideration for its potential translation, and relying solely on passive dissemination practices like journal articles and conference presentations isn’t really knowledge translation or translational research. Guided by established methods, and a host of resources (check out our top 10 list as an example), researchers of all disciplines have the ability to actively engage in efforts to incorporate translational principles into their work.
This definitely looks very different for basic and clinical researchers. Where clinical researchers studying a disease will often be able to contribute to knowledge synthesis (think systematic reviews) and can develop knowledge tools/products (like a diagnostic test), a basic researcher might be more limited to review articles or systematic reviews of animal studies. Similarly, where a clinical study may have stakeholders identified (such as a national group for people with a certain disease, or clinicians working in a specific medical field), a basic researcher may want to reach other academics in different fields, or share their discovery with the public via mainstream media. Where a clinical researcher might have plans to work with a pharmaceutical company to move a drug from clinical trials to the next phase of development, a basic researcher might decide to collaborate with researchers across the globe that do the same kind of work in a different cell type.
Even if you’re not sure as to how (or if) your discovery will impact patients and/or healthcare, the principles of knowledge translation can guide your work to be better aligned with the needs and priorities of stakeholders (and potential stakeholders). Expand your collaborations outside of your chosen field. Engage potential end users where you can. Think about how your work can be adapted to the local context of your region. Think about how your research findings may be important to another field (or another species). It is never a waste of time to think about the future implications of your research.
What are some creative ways you’ve bridged the ‘death valleys’ in your work? Tell us in the comments or Tweet at us @KnowledgeNudge.
References
- Reis SE, McDonald MC, Byers SJ. Crossing the Research Valleys of Death: The University of Pittsburgh Approach. Clin Transl Sci, 2008.
- Straus SE, Tetroe J, Graham ID. Knowledge Translation in Health Care: Moving Evidence Into Practice, 2nd Edition. BMJ Books, 2013.
