NEJM Perspective Calls for Implementation Science

April 30, 2014

While researchers at leading universities have made major scientific discoveries that advance understanding of the global HIV epidemic, translating the benefits of this knowledge into better health for communities around the world has been left to government agencies and non-governmental organizations. 

In the latest issue of the New England Journal of Medicine, an opinion piece by  Wafaa El-Sadr, MD, MPH, professor of Epidemiology and Medicine and director of ICAP at Columbia University’s Mailman School of Public Health, in collaboration with co-authors Neena Philip, MPH, and Jessica Justman, MD, makes a compelling argument for academic institutions to translate discoveries and inform practice at multilateral agencies, local government and the community level. El-Sadr argues for universities expanding their central mission of educating students, training the next generation of scholars and researching new discoveries, and embrace societal challenges more fully by pursuing a wider range of implementation research. Such research can contribute to solving problems through enabling a path to effective implementation of research findings into real world advances.

“Key discoveries remain confined to publications in journals and books underutilized by the people most in need of them,” according to Dr. El-Sadr and co-authors. They attribute this to the limited knowledge about how best to implement and scale-up discoveries. They cite examples of such missed opportunities and point to how the HIV epidemic compels a transformation of traditional academic priorities. 

The authors call for academia to reexamine the type of research they most value and to foster research in implementation science— the study of methods that translate research findings into common practice. “It is time to not only scale-up research, but also create a supportive environment for academics who pursue this path.”

The Perspective piece acknowledges the challenges that will come from moving in this direction.  How will this new model fit within traditional discovery research priorities?  Can academic institutions provide the support multidisciplinary teams need to engage in implementation science?  Will such research meet the required quality standards?  Nonetheless, pursuing discovery of the “what” while elucidating the “how” may bring broader benefits with an expanded academic mission that is inclusive of the social mission of universities.  

Read the Perspective.