Director’s Posts about Clinical Research and Trials (All Items)

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Citizen Science

Meredith, a 15-year-old high school student from San Diego, wrote this year’s breakthrough paper on modeling global epidemics. An 11-year-old boy from upstate New York solved a problem in protein folding using a computer game called Foldit. And an octogenarian working with his retired physician partner created the Cinderella Therapeutics Foundation in Holland to launch rapid trials of drugs rescued from industry.

These are a few of the stories from the Sage Bionetworks Commons Congress in San Francisco this weekend, supported by Google and the Kauffman Foundation for Entrepreneurship. The Congress brought together a motley crew of computer geeks, bioinformatics scientists, genomics gurus, and patient advocates for two days of non-stop brainstorming about how to use innovation to empower patients.

You might not expect that a meeting with talks on managing “big data” or “open source tools” would be edgy or passionate. In fact, this Congress could have been called Occupy Science. We heard about new tools to give patients ownership of their medical information and research subjects ownership of their informed consent. We heard about projects to share research data broadly and publish research results freely. And we heard from patients who had to create their own clinical trials and their own organizations to get answers.

Beyond the passion—and there was a lot of passion at this meeting—the Congress captured an emerging trend. Just as technology has democratized communication, it is transforming science or, more accurately, the culture of science. Academic science has been based on a model of individual achievement, where success is defined by what and where a scientist publishes. While this system has worked spectacularly well in some areas, the success of “big science” like the Human Genome Project has demonstrated the power of large, collaborative teams. Recent technologies have actually created a new space in between the small lab and big science models. Powerful, affordable sequencing and computational tools have “democratized” much of what used to be done only in big science teams, empowering individual labs or even non-scientists to contribute in big ways.

Technology has created opportunity—that’s hardly news. The gist of this meeting was not about technology but about changing the culture to accelerate progress on targeted treatments for cancer or reducing mortality from mental illness. How do we change the culture? The Occupy argument makes three claims. First, innovation will come from collaboration between scientists, clinicians, and patients, with patients recognized as the experts and given control over the use of their data. As Kathy Giusti of the Multiple Myeloma Research Foundation said it, “power to the patient.” Second, taxpayer funded research must be accessible to taxpayers or, as Heather Joseph of the Scholarly Publishing and Academic Resources Coalition said, “set the default to open.” And third, the barriers to treatment development will be overcome by new precompetitive partnerships: collaborations with open sharing of data between industry, academia, and government. This would be nothing less than a revolution in how science progresses, driven by projects like the oddly named Arch2POCM (PDF File)External Link: Please review our disclaimer..

We don’t know if this revolution will succeed, if success is measured by better diagnostics and therapeutics. But I can say this with certainty: what we are doing now has not delivered as quickly or as completely as most of us want. Of course, the problems are complex and often we don’t know enough to translate a scientific discovery into a breakthrough for health. Technology cannot fix this, but technology can alter the culture of science just as it has altered the culture of communication. Empowering the public, making data public, and creating models for open innovation are all experiments worth running. Time matters. The message from the Sage Bionetworks Commons Congress is that we can begin to change the culture of science right now.

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The Future of Psychiatry (= Clinical Neuroscience)

While fewer medical students are choosing psychiatry in the U.K., in the U.S. psychiatry is attracting increasing numbers of elite MD-PhD students who want to do research. These young scientists are committed to developing a new scientific basis for clinical care.

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Treatment Development: Where do we go from here?

Dr. Insel discusses opportunities for treatment development.

NIMH’s Top 10 Research Advances of 2011

Treatment Development: Where do we go from here?

Dr. Insel discusses opportunities for treatment development.

Treatment Development: The Past 50 Years

Dr. Insel discusses the state of psychiatric research and development (R&D) in the public and private sectors

Antidepressants: A complicated picture

Dr. Insel discusses the complicated nature of research on the efficacy antidepressants.

Neuroscience Advances Showcased in Washington

Dr. Insel reflects on an exciting neuroscience conference where an increasing interest in neuropsychiatric disorders was evident.

Making the Most of our Interventions Research

Dr. Insel provides a vision for future clinical research.

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Taking Clinical Research to the Next Level

Dr. Insel discusses the evolution of clinical research and changing priorities in clinical research funding.

Microbes and Mental Illness

Increasing evidence linking strep infection to OCD in children suggests that microbiomics may prove an important research area for understanding and treating mental disorders.

Three Principles for Clinical Research

Dr. insel discusses two important initiatives that will have a broad impact on NIMH’s clinical research portfolio.

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