Comprehensive Medical Research Networks

There has been a growing trend in the medical research community over the past few years to establish formal collaborations among biomedical researchers and practicing clinicians in order to:

• foster translational research
• expand clinical trials
• conduct research on clinical practices and informatics in order to enhance evidenced-based medicine

These research collaborations go by a number of names and may be focused on a particular disease or a specific type of clinical practice. For example, in the case of primary care physicians, such clinical research programs are referred to as Practice-Based Research Networks. Another commonly used term is Clinical Research Networks. Because we will discuss such research collaborations in a broad context, they are referred to them as Comprehensive Medical Research Networks (CMRN). The figure depicts the basic concept of a CMRN

Comprehensive Cancer Centers (CCC), such as the H. Lee Moffitt Cancer Center and Research Institute in Tampa, serve as an example of the value of CMRNs. As defined by the National Cancer Institute (NCI), a comprehensive cancer center has demonstrated reasonable depth and breadth of research activities in each of three major areas: laboratory, clinical, and population-based research, with substantial transdisciplinary research that bridges these scientific areas. An NCI-designated CCC must also demonstrate professional and public education and dissemination of clinical and public health advances into the community it serves. In other words, NCI-designated CCCs run the full gamut including very basic research, translational research, clinical trials, patient treatment, psychosocial counseling, alternative medicine, and patient and public education. There is literally no aspect of cancer that is not dealt with in some way in a CCC. (Note: Although Moffitt Cancer Center is an NCI-designated CCC, there are some comprehensive cancer centers in Florida that do not carry this NCI designation such as the Sylvester Comprehensive Cancer Center at the University of Miami and the Shands Cancer Center at the University of Florida.)

The Comprehensive Medical Research Networks Concept

CCCs show the value of integrating biomedical research, translational research, patient care, clinical research and patient education, as is the goal of CMRNs. But CCCs are different from CMRNs in two important respects. First, CCCs primarily involve a single institution rather than a network of multiple organizations. Second, they exist largely in a single geographic location, although they may have branch clinics in other locations. For example, the Moffitt Cancer Center in Tampa and through its Total Cancer Care (TCC) initiative has several affiliates inside the state, as well as nationally, and internationally. CMRNs can learn from the experiences of CCCs and the advances in information technologies (email, webinars, websites, and databases) can help overcome many of the limitations of multiple organizations spread across a broad geographic area.

Other examples of comprehensive medical research networks in include:

• The National Institutes of Health's Clinical and Translational Science Awards (CTSAs)). The CTSA program, launched in 2006, now includes 46 medical research institutions in 26 states. When the program is fully implemented, it will support approximately 60 CTSAs across the nation.
• Asthma Clinical Research Network supported by the National Heart, Lung and Blood Institute (NHLBI), a part of the National Institute of Health. The network consists of nine clinical centers and one data coordinating center.
• Muscular Dystrophy Association Clinical Research Network with five clinics devoted to ALS (amyotrophic lateral sclerosis, or Lou Gehrig's disease) and five focusing on Duchenne muscular dystrophy.