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IOM Urges Centralizing CTSA Leadership, Expanding Collaborations in Program's Next Phase

NEW YORK (GenomeWeb News) – The National Institutes of Health's Clinical and Translational Science Awards program is "contributing significantly" to the development of advancement of new clinical and translational research in the US, but some organizational changes, refocusing, and accountability could improve the program, according to the Institute of Medicine.

In a new report out today, the IOM laid out a set of steps that the leadership at the National Center for Advancing Translational Sciences could take to make the CTSA program, which received $488 million last year, "more efficient and effective."

The IOM, which NIH commissioned to study the CTSA program last year, concluded that the it could benefit from a more centralized leadership structure, more focused strategic planning, and more measurable goals, and that it should take steps to enhance its training and education efforts, to engage with stakeholders communities, and place a special emphasis on child health initiatives.

NCATS Director Chris Austin said in a conference call today that he welcomes the IOM's recommendations, calling them "visionary" and "compelling," and said he plans to begin implementing them immediately.

The flagship program of the fledgling NCATS institute, CTSA funds 61 programs across the US with the aim of boosting the national academic translational science enterprise, improving all areas of translational research, and training investigators for a robust translational science workforce.

After reviewing the CTSA program's activities since its launch in 2006, the IOM panel found that the program has succeeded in its mission of establishing "academic focal points for clinical and translational research."

"Its 61 awardees can have a broad impact on research practices and informatics and, ultimately, on patient care and individual health outcomes," and the CTSA program continues to provide the funding and infrastructure around the country necessary to conduct clinical and translational research, the IOM found.

But the reviewers also noted that more progress will be required to create "a proactive research environment" that is "responsive to the demands of a continually evolving healthcare landscape."

For its next phase, dubbed CTSA 2.0, the program must "set the goals and create the incentives for these 61 sites to function as the core of a national network" that supports, initiates, and sustains collaborative research that engages academic institutions, NIH and its many centers, partners in industry, and other network partners, IOM urged.

To begin this process, the IOM report recommends that NCATS should take on a stronger leadership role in the program and centralize its governance. So far, the program has been primarily self-governed by the CTSA Consortium, made up of three leadership committees that oversee numerous other committees.

Although the current grassroots structure has "encouraged creativity and innovation," the IOM committee said in the next phase the institute should work with its CTSA partners to reconfigure and streamline the current structure into a single NCATS-CTSA Steering Committee.

Austin said in a statement today that NCATS will increase its active leadership role in the program and will seek to streamline and reconfigure it to be more efficient.

The IOM report suggests that the institute should update its CTSA mission statement to reflect the program's overarching purpose and start a strategic planning process in collaboration with its CTSA partners to "update the CTSA mission and adopt a single set of measurable strategic goals."

"Designation of clear, measurable goals and objectives that address critical issues across the full spectrum of clinical and translational research will be one of our first tasks," Austin said.

The IOM added that NCATS should seek to leverage the strengths of individual CTSA centers and to enhance collaborations between them and emphasize interdisciplinary, team-based approaches in training, education, and research.

The committee said that collaboration will be a key feature in achieving the CTSA mission, and recommended that NCATS should be reaching out to public and private entities and stakeholders, including industry, patient advocacy groups, healthcare providers, and others to pursue new partnerships. The CTSA program also should establish an "innovations fund to promote collaborative pilot studies and other initiatives," the report said.

Because a well-trained research workforce is a critical part of translational science, the committee also recommended that NCATS continue to emphasize innovative training and mentoring and that the CTSAs use flexibility and best practices for attracting new scholars and trainees.

IOM also said that some CTSA centers that have well established child health research programs should help to lead other CTSAs to expand their research initiatives that are focused on children.

Austin said that the report lays out a "cogent and inspiring vision for the future of the CTSA program."

"Drawing upon the enormous wisdom and enthusiasm of all our stakeholders and using this report as a roadmap, together we will realize the transformative potential of the CTSA program for science and health," Austin said.

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