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Barbara J. Culliton Extracting Knowledge From Science: A Conversation With Elias Zerhouni Health Affairs, May/June 2006; 25(3): w94-w103. [Abstract] [Full Text] [PDF] [Full Text] [Reprints & Permissions]

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Interdisciplinary Primary Care Community-Based Research

Janine E. Janosky, Ph.D.   ( 7 September 2006 )

Interdisciplinary Primary Care Community-Based Research 7 September 2006
Janine E. Janosky, Ph.D., Associate Professor University of Pittsburgh School of Medicine, Department of Family Medicine Send comment to journal: Re: Interdisciplinary Primary Care Community-Based Research jej{at}pitt.edu Janine E. Janosky, Ph.D.	I read this interview with interest. Under the direction of Dr. Elias A. Zerhouni, the NIH has proposed a Roadmap [1] whose overarching goal is to accelerate the pace of discovery in the life sciences and the translations of effective therapies from bench to bedside.[2] Paramount to achieving this overarching goal is the premise that scientific advances are made from the interface of traditional disciplines with integrative or nterdisciplinary investigators from diverse research backgrounds. Biomedical research is evolving into an interdisciplinary pursuit, [3] involving the interdigitation of several disciplinary approaches in a nourishing and systematic manner, [3-4] and through this integration of traditional disciplines new scientific advances can be made. The Research Teams of the Future [1] will require individuals trained with the understanding of the importance and the ability to cross disciplinary boundaries, including having the collaborative skills to participate in integrative research teams. [3-4] Primary care research including pediatrics, internal medicine, and family medicine has been historically university-based; however, in response to the NIH Roadmap, there is a need for another discipline within primary care research. This discipline of interdisciplinary primary care community-based research will need a different developmental path, resulting in multidisciplinary and interdisciplinary training. Methodological issues of import to primary care community-based research include, among others: (1) recruitment of multiple levels of data such as communities, multiple medical practices, diverse physicians specialties, and patients; (2) advanced statistical concepts such as hierarchical linear modeling and weighted sampling; (3) dissemination of results to multiple levels of stakeholders such as health plans, physician practice groups, and patient advocacy groups; and (4) inclusion of a diverse group of professional as members of the research and clinical teams. As an addendum to the concept of the bench-to-bedside model for translational research, [5] with the inclusion of interdisciplinary primary care community-based research as a discipline, the translation of traditional bedside research findings can be made to impact care delivered and received in the primary care community-based setting. As disease burden shifts from acute conditions to chronic conditions that are primarily seen in community practices, [2] the need for research addressing the translation of clinical research finding into community-based applications and direct community-based research will increase. Interdisciplinary primary care community-based research integrates the analytical strengths of diverse scientific disciplines working collaboratively to answer a scientific inquiry. To successfully produce the kind of new knowledge needed to conduct interdisciplinary primary care community-based research, future researchers must understand the issues and possess the necessary methodological skills. Literature Cited 1. NIH Roadmap Initiative, http://nihroadmap.nih.gov 2. Zerhouni EA. Translational and Clinical Science-Time for a New Vision. New England Journal of Medicine, 2005; 353: 1621-1623. 3. Mallon WT, Biebuyck JF, Jones RF. The reorganization of basic science departments in U.S. medical schools, 1980-1999. Academic Medicine, 2003; 78 (3): 302-306. 4. Gershon D. Laying a firm foundation for interdisciplinary research endeavours. Nature. 2000; 406 (6791): 107-108. 5. Kuchn BM. PhD programs adopt bench-to-bedside model to speed translational research. Journal of the American Medical Association, 2006; 295 (13): 1506-1507.