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GUEST EDITORIALS

Introduction to Translational Research for Orthotists and Prosthetists

Dillon, Michael P. PhD, BPO(Hons); Fatone, Stefania PhD, BPO(Hons)

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Journal of Prosthetics and Orthotics: July 2018 - Volume 30 - Issue 3 - p 120-121
doi: 10.1097/JPO.0000000000000192
  • Free

In July 2013, an expert working group met in Chicago to review the American Academy of Orthotists and Prosthetist’s State-of-the-Science Program and, among its many goals, sought to identify new ways to disseminate the findings of the systematic reviews and evidence reports commissioned by the Academy.

Members of the working group discussed opportunities to use translational research approaches to disseminate the findings of the Academy’s State-of-the-Science Program and thereby ensure their desired impact on clinical practice was realized.

Over time, we have directed a number of colleagues to the State-of-the-Science Program report as they have looked to translate their research to new audiences and, as such, we are delighted that the American Academy of Orthotists and Prosthetists has agreed to make this publically available through the Journal of Prosthetics and Orthotics. The intent is to raise awareness of what translational research is, why it is important, and how to go about writing translational research.

WHAT IS TRANSLATIONAL RESEARCH?

In its most basic form, translational research describes efforts to bring the findings of medical and scientific research into clinical practice.1,2 Usually, the findings from research are communicated in peer-reviewed journals that emphasize reporting of the experimental methods. While detailed reporting of the experimental methods is important to demonstrate the rigor of the research and engender confidence in the conclusions, the salient clinical messages are not always clearly articulated. Without the ability to translate what is learned from research into health care practice, the value of scientific discoveries and the potential impact they can have on the lives of people for whom the research was originally intended is limited.

Over the last decade, there has been increasing recognition of the importance of translational research in health care. This is evidenced by the significant investment in translational research from federal agencies such as the National Institutes of Health (NIH), which established the National Center for Advancing Translational Sciences.3

WHY IS TRANSLATIONAL RESEARCH IMPORTANT?

Translational research aims to clearly articulate an important clinical message in a way that makes the findings from research practical for clinicians to implement in practice.

Without the constraints of reporting detailed experimental methods, translational research is often presented as a short communication that is easily read by non-researchers. Given that translational research does not typically include details of the research method, it relies heavily on previously published original research and, more often, syntheses of original research (e.g., systematic reviews) to provide the necessary supporting evidence and credibility.

Translational research can be an effective way to communicate important messages beyond traditional discipline boundaries and to policy makers, thereby amplifying the influence of the original research. Some members of the general media scan journals specifically for these translational research articles because they are readily understood by a wide readership and easily adapted into newsworthy communications.

HOW DO YOU WRITE TRANSLATIONAL RESEARCH?

Many journals support translational research efforts. Sometimes translational research articles are published as “clinical focus” or “perspective” articles,4 which can make them difficult to identify at first glance. Prosthetics and Orthotics International, for example, publishes an “expert clinical view point,”5 while Archives of Physical Medicine and Rehabilitation includes a periodic “Editorial Commentary.”6,7 The American Academy of Orthotists and Prosthetists has published a number of “evidence notes”8 designed to translate key findings from the State-of-the-Science Program to clinicians. There are also a number of journals dedicated solely to publication of translational research (e.g., Translational Oncology and Journal of Translational Medicine).9,10

In deciding whether to publish a translational research article, it is important to be clear about the purpose of the communication as well as the intended audience. It may be helpful to look at the types of articles published by particular journals given that the style and length of the communications vary. It is also possible to pitch an idea for a translational research article to the journal’s editor who will be able to determine if the message is of interest to the journal’s audience.

As an illustrative example, Dillon et al.11 wanted to raise awareness about emerging research that challenges long-held views about the benefits of partial foot amputation. Much of the original research on the topic is not readily accessed by surgeons because it is published in prosthetics and orthotics, gait analysis, or rehabilitation-specific journals. By translating this research to a medical/surgical audience via publication of a “perspective” piece in the Medical Journal of Australia, the authors challenged clinical understanding in hopes of better aligning decisions about amputation surgery with the emerging evidence. Letters to the editor written in response to this translational research article indicate that discussion on the topic is occurring among surgeons.12,13 Subsequent media interest in the article resulted in additional translation of the clinical message in online magazines,14,15 demonstrating the potential impact of translational research.

The following steps might help guide the process of writing a translational research article.

  • Identify a message that is both important to clinical practice and supported by published research.
  • Be clear about the purpose of the communication and the intended audience.
  • Choose a journal that is regularly read by the target audience and publishes translational research articles.
  • Read several examples to become familiar with the format and style.
  • Consider pitching the idea to the journal’s editor to see if he or she agrees that the message is of interest to the readership.
  • Draft the article, remembering that the purpose is to translate findings from original research in a way that makes it easy for clinicians to implement in practice.
  • Make sure the article is accessible to a wide readership; keep the message simple, avoid complex terminology, and rely on published research to provide the supporting evidence.
  • Have a draft critiqued by people knowledgeable on the topic, including representatives from among the intended audience.
  • Submit for publication.

REFERENCES

1. Woolf SH. The meaning of translational research and why it matters. JAMA 2008;299(2):211–213.
2. Rubio DM, Schoenbaum EE, Lee LS, et al. Defining translational research: implications for training. Acad Med 2010;85(3):470–475.
3. National Center for Advancing Translational Sciences. National Institutes of Health 2017. Available at: http://www.ncats.nih.gov/.
4. Medical Journal of Australia. 2017. Available at: https://www.mja.com.au/.
5. Robinson C, Major MJ, Kuffel C, et al. Orthotic management of the neuropathic foot: an interdisciplinary care perspective. Prosthet Orthot Int 2015;39(1):73–81.
6. Teasell RW, Murie Fernandez M, McIntyre A, Mehta S. Rethinking the continuum of stroke rehabilitation. Arch Phys Med Rehabil 2014;95:595–596.
7. Dillon MP, Fatone S. Deliberations about the functional benefits and complications of partial foot amputation: do we pay heed to the purported benefits at the expense of minimizing complications? Arch Phys Med Rehabil 2013;94:1429–1435.
8. American Academy of Orthotists and Prosthetists. 2017. Available at: http://www.oandp.org/publications/evidencenotes.
9. Translational Oncology. 2017. Available at: http://www.transonc.com/.
10. Journal of Translational Medicine. 2017. Available at: https://translational-medicine.biomedcentral.com/.
11. Dillon MP, Fatone S, Morris ME. Partial foot amputation may not always be worth the risk of complications. Med J Aust 2014;200(5):252–253.
12. Lazzarini PA, Malone M, Wraight PR. Partial foot amputations may not always be worth the risk of complications. Med J Aust 2014;200(11):634–636.
13. Norman PE, Schoen DE, Nedkoff L. Partial foot amputation may not always be worth the risk of complications. Med J Aust 2014;200(11):634–636.
14. Swannell C. Uncertainty in diabetes amputation. MJA Insight 2017 Available at: https://www.mja.com.au/insight/2014/9/uncertainty-diabetes-amputations.
15. Hanracan C. Which part of the foot is best to go forward? Medical Observer 2014. Available at: https://www.medicalobserver.com.au/medical-news/diabetes/which-part-of-the-foot-is-best-to-go-forward?utm_medium=email&utm_campaign=17-06%20NON-s4%20Tues&utm_content=17-06%20NON-s4%20Tues%20CID_8d8a817b1f03b939d2b025bc42071536&utm_source=Email%20marketing%20software&utm_term=Which%20part%20of%20the%20foot%20is%20best%20to%20go%20forward.
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