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Accelerating the translational medicine cycle: the Academia Europaea pilot

To the Editor—Translational Medicine (TM) is among the main challenges of the 21st century; its development is essential for the application of scientific results for community benefit.

Although several developments have been achieved in the field, there is still room for improvement in implementing scientific results in healthcare. More than 1.4 million articles are published each year, as reported on PubMed; however, much of this knowledge is not applied in everyday practice. Based on a report from the European Commission’s European Statistical Office, around 1.7 million people under 75 years of age die in Europe every year, but 1.2 million of these deaths could have been avoided through effective primary prevention and public-health intervention1.

The Academia Europaea, one of the leading advisory bodies of the European Commission, thus initiated the development of a new TM model that facilitates and accelerates the application of scientific knowledge for community benefit2. The new cycle model equally focuses on healthcare, the acquisition of new scientific findings, the digestible summation of results, and the communication of scientific knowledge to all stakeholders, including patients, healthcare professionals, pharmaceutical companies and policymakers. The model has been piloted at the Centre for Translational Medicine at the University of Pécs (UP-CTM) in Hungary, with great success, which made UP-CTM one of the most efficient and visible centers for TM in Eastern and Central Europe within five years.

The TM cycle model in healthcare was trialed in an eight-bed UP-CTM patient care unit that focused on managing acute pancreatitis. Patient coordinators, clinical research administrators, PhD students, nurses, and junior and senior doctors joined forces in the day-to-day work. This team ensured the application of available evidence-based guidelines and, notably, built up activities for healthcare delivery science—for example, the team enrolled patients in clinical trials and patient registries, and organized and analyzed the diagnostic and treatment pathways. In a year, we achieved a two-day reduction in the length of hospitalization per patient, a marked decrease in antibiotics administration, and a two-thirds drop in mortality. Due to the healthcare-delivery-science activity, patient-care costs also fell by 25% (ref. 3) (Fig. 1a).

Fig. 1: Five-year results of implementation of the Academia Europaea TM cycle model.
figure 1

a, Total mortality and mortality from moderate acute pancreatitis (MAP), moderately severe acute pancreatitis (MSAP) and severe acute pancreatitis (SAP) before (left) and after (right) implementation of the UP-CTM patient care unit. b, Antibiotics use for acute pancreatitis before and after implementation of the UP-CTM patient care unit; pie charts indicate the proportion of patients who received antibiotics (light blue) or not (teal). c,d, Clinical databases and biobank samples (c) and collaborations (d) included in the UP-CTM after the initial five-year period. e, Yearly scientific output (horizontal axes) before and after implementation of the UP-CTM. D1, publications in the top 10% of the journals; Q1–Q4, publications in the first quartile (top 25%) and second, third and fourth quartiles of the journals, respectively. f, Components of the interdisciplinary unit of the UP-CTM. IT, information technology; AI, artificial intelligence. g, Educational efforts and support of the UP-CTM. h,i, Outreach of the UP-CTM to policymakers (h) and the community (i) during the COVID-19 pandemic.

The model was subsequently tested in two other hospitals. At the Szent György University Teaching Hospital of Fejér County (Székesfehérvár, Hungary), a similar healthcare delivery science–based patient care unit for acute pancreatitis was launched. As a result, the use of antibiotics substantially decreased. The duration of hospitalization dropped by an average of one day per patient (Fig. 1b). At the Heim Pál National Pediatric Institute (Budapest, Hungary), a scientifically constructed cystic-fibrosis registry, which also examined glucose metabolism in detail, facilitated the early diagnosis of diabetes mellitus in 14% of the patients; these would have been missed by the previous system. In addition, nine children were identified as having impaired glucose tolerance; this may allow earlier diagnosis and treatment of established cystic fibrosis–related diabetes.

After the projects involving acute pancreatitis, we broadened our patient registries and clinical trials to a wide range of medical disciplines (Fig. 1c,d). Notably, these clinical databases and biobank samples substantially added to the 300 publications by UP-CTM over the five years, which may substantially contribute to the implementation of scientific results for community benefit. The outstanding networking is well illustrated through UP-CTM’s joint publications involving more than a thousand researchers in the five years (Fig. 1e).

To support patient care, scientific activity and communication, we set up an interdisciplinary unit at the outset with several different disciplines, including patient coordination, biostatistics, informatics, data management, artificial intelligence, legal support and communication. Notably, the unit accelerated scientific activity, supported patient care and communication, and created 51 jobs with new professional content by the end of the five years, which is extremely important in a century during which the demand for professionals is decreasing in numerous fields (Fig. 1f).

A shift was necessary for the academic field and communication as well. Medical professionals must understand scientific results to deliver high-quality patient care; therefore, our center developed a new ‘learning by doing’ education module in which 45 young physicians learned the scientific methodology. The program’s strength is emphasized by the fact that doctors from ten different cities in four countries participated in the training program. At the same time, we developed a complex Clinical Research Administrator training program accredited and tested in the fifth year. During this period, printed educational materials and online educational videos were made available for healthcare professionals; these have been particularly useful during the COVID-19 pandemic. Grant committees also recognized the potential of the TM cycle approach (Fig. 1g).

For the best implementation of scientific results in practice, information must also be disseminated to non-medical people. With the onset of the COVID-19 pandemic, we immediately established the Translational Action and Research Group against Coronavirus (KETLAK) to reduce the coronavirus-induced health damage and deaths. Two extensive reports were presented directly to Hungary’s national epidemiological policymaking body by our KETLAK group in April 2020, which facilitated the country’s management of the first wave of the COVID-19 pandemic with excellent results4. We launched the PROACTIVE-19 study, providing health education to the community from the outbreak of this pandemic5. We had approximately 150 media appearances, which also played an essential role in communication to the community (Fig. 1h). Of course, we concentrated not only on COVID-19 but also on other diseases. In total, we helped the population with 31 patient-education videos, 43 social-media appearances and 13 printed patient-information leaflets (Fig. 1i).

What does the future hold? It is hard to predict, but it is certainly up to us. We strongly believe that disseminating the model and highlighting the successes it achieves can help. It is an excellent sign that Semmelweis University has already invited us to build the TM cycle in Budapest; moreover, several European and American universities have already expressed interest in introducing the TM cycle model or further developing their existing models. Is this model perfect? Certainly not, but it represents a considerable advance.

References

  1. OECD & European Observatory on Health Systems and Policies. OECDiLibrary https://www.oecd-ilibrary.org/social-issues-migration-health/hungary-country-health-profile-2019_4b7ba48c-en (28 November 2019).

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Correspondence to Péter Hegyi, Bálint Erőss, Ferenc Izbéki, Andrea Párniczky or Andrea Szentesi.

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Hegyi, P., Erőss, B., Izbéki, F. et al. Accelerating the translational medicine cycle: the Academia Europaea pilot. Nat Med 27, 1317–1319 (2021). https://doi.org/10.1038/s41591-021-01458-8

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