For better cures, let’s do science differently

Posted on August 18, 2012 in Health Policy Context

Source: — Authors: – commentary
6 August 2012.   Donald Stuss

Most everyone believes medical research is necessary. The problem is that it takes too long for research to be translated into meaningful outcomes for patients and new enterprises for the economy.

Worse still, the time from discovery to treatment will only slow as worldwide economic problems bring major cuts to government and private-sector research.

To understand what’s at stake, consider a health problem that is as insidious as it is devastating to Canadian families: dementia.

According to a study published by the Alzheimer Society of Canada, the prevalence of Alzheimer’s disease and related dementias will grow from the current 500,000 Canadians to more than 1.1 million within a generation. This explosive growth will drive the total economic burden associated with the disease from $15-billion to more than $153-billion.

Clearly something must be done to stem this rising tide. But what? How do we address our country’s astonishing need for improved diagnoses, treatments and cures for dementia given the snail-like pace with which current research practices deliver benefits to patients and spawn new companies and, with them, new jobs.

The answer is by doing science differently.

A unique model to do just this is at the heart of the Canadian Consortium on Neurodegeneration in Aging, whose creation was announced recently in Vancouver by the Canadian Institutes of Health Research.

Like other emerging approaches, including the Ontario Brain Institute’s Integrated Discovery System, the consortium’s model emphasizes the support of platforms (e.g., imaging, genetics) used by researchers from different institutions. The end result: co-ordinated efforts, more patients in studies and novel investigations both within and across diseases.

Of course, the applicability of these models isn’t limited to dementia research. Indeed, we believe that their application could transform how new diagnostics, treatments and even cures are discovered and delivered to the huge number of Canadians who are touched by brain disorders, ranging from autism to depression to schizophrenia.

There are four common elements to these emerging models for discovery.

First, they assume that the millions of Canadians who are affected by disease should play a meaningful role in shaping the development of their treatments. Disease associations, spurred on by patients and their families, must have the opportunity to engage researchers and clinicians at all points along the reseach-and-development pathway – not just as end users but as “discovery developers.”

The second element is to accept that all research, whether “basic” or “applied,” is part of a single continuum, with some research questions closer to impact than others. For example, without the basic and seemingly useless research on the electromagnetic properties of blood carried out by Linus Pauling and Charles Coryell in 1936, the whole field of magnetic resonance imaging would simply not exist.

Third, breakthroughs will come sooner when clinicians and researchers from many disciplines, disease foci, research platforms and institutions all start working together. The fact is much of science today is siloed. Genetic and behavioural researchers don’t talk enough; depression researchers typically don’t work with Alzheimer’s researchers – even though these disorders have much in common.

Fourth, scientists and industry need to work together more effectively. Virtually everyone agrees that Canadians are brilliant researchers, but we punch far below our weight when it comes to moving our knowledge to practical value. Data needs to be collaboratively shared. Industry needs to be at the table early in the process in order to effectively guide research discovery, health outcomes and commercial impact.

Ultimately, it is not so much that we need to ask new questions about dementia and other disorders of the brain; it is that we need to answer the questions in a more collaborative and multidisciplinary way.

The bigger question isn’t “Can we afford to spend money on research?” It’s “How can we invest in better ways of doing science?”

Donald Stuss is president and scientific director of the Ontario Brain Institute, a province of Ontario initiative.

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