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University of Rochester Clinical and Translational Science Building (CTSB): Dream to reality
Dr. David Guzick, M.D., Ph.D.
April 17, 2008
In 1999, a task force on clinical research, chaired by Richard Reichman, MD and charged by Dean Lowell Goldsmith, presented its report on what was needed to promote clinical research at the University of Rochester Medical Center. This was at a time when the Kornberg Medical Research Building was nearing completion and we were in the midst of the 1996 Strategic Plan for basic research. A principal recommendation was the construction of a clinical research building to promote synergy among the many and diverse elements of the clinical research community at the University. There was tremendous enthusiasm for this recommendation among Task Force members and the clinical research community.
The dream was born. This newsletter tells the story of how the dream became a reality: On Thursday, April 10, 2008, we learned from President Seligman that the NYS Assembly and Senate voted to include $50 million for the University of Rochester Clinical and Translational Science Building (CTSB), and that Governor Paterson has indicated that he will sign the legislation.
So, the check is not yet in the mail, but we felt that it was close enough to celebrate the passing of this budget and communicate this message to the internal medical school community. If you can, please join us in this celebration on Friday morning.
The above Task Force report, in many of its other recommendations, anticipated the NIH Roadmap, with its emphasis on clinical and translational science (CTS). The overall objective of CTS is to create new knowledge and techniques that are applicable to improving the diagnosis, prevention and treatment of human disease, and to enhancing clinical practice in the community. As envisioned in the NIH Roadmap for Medical Research, “clinical research is the linchpin of the nation's biomedical research enterprise… To accelerate and strengthen the clinical research process, a set of NIH Roadmap initiatives will work toward improving the clinical research enterprise by adopting a systematic infrastructure that will better serve the evolving field of scientific discovery. This effort, which complements the other initiatives that comprise the NIH Roadmap, will provide the necessary foundation for advancing basic and clinical research. With the NIH Roadmap in action, investigators will be better poised to translate basic discoveries into the reality of better health for our nation.” (NIH Office of Analysis and Strategic Initiatives)
To help advance realization of this vision, NIH created the Clinical Translational Science Award (CTSA), which the University of Rochester secured successfully in 2006 on the first round of a highly competitive, peer-reviewed application process. As articulated by Dr Elias Zerhouni, Director of NIH (May 23, 2005): “…An academic and intellectual home is needed for clinical and translational sciences. This academic home should include a cadre of well-trained investigators and integrated resources that will advance the new intellectual discipline of clinical and translational sciences.”
The idea of an academic home for CTS was a central concept in the RFA for the CTSA grant. At Rochester, we were well poised to implement the idea of an academic home because of the careful thinking that had already been devoted to the development of an academic, intellectual and geographic home for clinical and translational science. Thus, a centerpiece of the University of Rochester CTSA application was a plan for the design and construction of a Clinical and Translational Science Building (CTSB) to provide this home.
On January 26, 2007, we presented a plan for CTSB to the President and other senior University officials. This was facilitated by a superb white paper written by Mark Michaud of our Public Relations Office. As a result of this presentation and other discussions, the President made the CTSB the University’s lead legislative priority. We are deeply indebted to President Seligman, and to our government relations staff—including Peter Robinson, Josh Farrelman and Amy Happ—for successfully making the case for CTSB to the State legislators and the Governor’s office.
T he goal of the CTSB is to create an environment that will effectively catalyze the translation of basic science discoveries into clinically useful knowledge and treatments to improve health and health care. The CTSB at the University of Rochester is the timely and logical expression of years of deliberate and focused effort during which the infrastructural building blocks for clinical and translational research were successfully assembled. Like the new URMC biomedical research facilities that have fostered the nurturing and growth of basic research, the CTSB will enhance the application of biomedical and translational research to prevent illness, foster early diagnosis, identify risk factors for disease and its progression that can be used for early intervention, and develop treatments that make a difference for our patients and families.
It was also envisioned that the CTSB would be the hub for patient-oriented community outreach activities, whereby members of the community who participate in clinical investigation will have ready access to a safe, informative and supportive research environment, and whereby community-based physicians will have an opportunity to contribute to medical discoveries and disseminate new knowledge into best clinical practices.
The CTSB will serve to bring together, under one roof, in an efficient and self-nurturing environment, four interlocking components that will foster state-of-the-art clinical and translational science: (1) the requisite scientific disciplines, including biostatistics, informatics, epidemiology, outcomes research, clinical pharmacology, health economics, and socio-ethical studies; (2) critical support operations, including the offices of the Senior Associate Dean for Clinical Research, relevant staff in the Research Subjects Review Board, the Office of Research & Project Administration, the Technology Transfer Office, and the investigational pharmacy; (3) new CTSA-funded training programs in clinical and translational research for junior MD faculty and for MPH and PhD students, and (4) the actual conduct of translational and clinical research involving the key participation of the community and industry.
A key factor in the rationale for the CTSB building, in addition to the programmatic timeliness of its scientific, educational and community outreach activities, is that almost all of the research programs to be housed in the CTSB must (or should) move from their current locations in the next 2-3 years. Some are in space earmarked for other functions (School of Nursing, MRBX, St. Agnes School), some are in commercially leased space, and some are in old, poorly functional facilities that should be replaced (Mt. Hope Professional Building). Decompression of existing research faculty, and its salutary effect on indirect cost recovery, is thus an important consideration. Moreover, the opportunity to retrofit MRBX-ground as a 20,000 sq ft floor of wet-bench labs is on the critical path of the URMC Strategic Plan, and the overall project advances the Master Facilities Plan.
A partial list of clinical research programs to be housed in the CTSB, along with their annual external funding levels, are: Neurology Clinical Trials Coordinating Center ($19.6M), Heart Research Center ($8.3M), Neuromuscular Disease Center ($4.3M), Nursing Research ($3.0M), Smoking Cessation Center ($2.4M), Physician-patient communication and disparities research ($2.0M), Cancer control ($2.2 M), Oral health ($1.4M), and our CDC National Center for Deaf Health Research ($1.1M). In total, external funding for research in the CTSB will be $49.3 million annually when the building opens.
The CTSB will also have important direct and ripple effects on the Rochester economy. Research and development in general, including clinical and translational research, can provide a source of jobs and start-up companies. Moreover, clinical and translational research brings the opportunity for new treatments and diagnostic tests to those in the Rochester region who enroll in studies evaluating them. Patients enrolled in clinical studies benefit from excellent care by experts in their fields. Outstanding facilities and programs also attract the best and brightest physicians, nurses, and other clinical providers who would have their choice of medical centers in which to practice. The same applies to attracting medical and graduate students, as well as medical residents and fellows, to receive their education here. Some studies will involve community-based practitioners, whose careers and practices will be enriched and improved. Finally, a focus on the ethical aspects of clinical and translational research will assure that human research subjects’ safety and welfare is the first priority and that all patients are fully informed of the study’s potential risks and benefits.
A recent study of the direct, indirect, and induced economic impact of the CTSA was conducted by the Center for Governmental Research (CGR), an independent economics consulting firm. CGR’s analysis indicates that once the entire venture has matured in the fifth year, the immediate and catalytic impacts of the component CTSA projects will sum to nearly $30 million annually.
In summary, the CTSB represents the culmination of years of ground work that has successfully laid the foundation for transformational clinical and translational science at the University of Rochester. The goal is to improve the health of our patients and communities. This facility is directly in the path of the NIH Roadmap and its Clinical Research Re-Engineering initiative. The construction of the CTSB has been galvanized by the timely convergence of the national leadership represented by the CTSA award, space imperatives dictating the need for decompression, the desire for community outreach and economic impact, and the requirements of the Strategic and Master Facility Plans. Finally, the creation of 200,000 sq ft of new research space and the achievement of an extraordinary set of programmatic goals can be achieved at the relatively low cost of $2.3 million annually.
We know there will be scheduling conflicts for many; but if you can, please join us tomorrow at 11:00 a.m. in the Flaum Atrium to celebrate the CTSB.
Meliora,
David S. Guzick, MD, PhD
Dean, School of Medicine and Dentistry
University of Rochester
Dean's Newsletter
Posted May 28, 2009:
A Fond Farewell to the University of Rochester
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