The impact of impact

How can we understand the links between research and its economic and societal impacts? Ellen Charman from the UK’s Medical Research Council tells us more about recent research published in Health Research Policy and Systems.

Research impact has been in the spotlight a lot recently. For the first time, impact has been used by the four higher education funding bodies in the UK as a measure to assess UK university research and to allocate their funding. Universities submitted almost 7,000 case studies to the 2014 Research Excellence Framework (REF) exercise, each telling a story about how research has made an impact on society and/or the economy.

But interest in impact is not new. As far back as the early 17th Century, Sir Francis Bacon described a utopian society in which a nascent research system helped to meet the needs of society in New Atlantis, an unfinished work of fiction published a year after his death.

More recently there has been growing recognition that publically-funded researchers and research organizations have a duty to demonstrate their contribution to society, or their ‘return on investment’. This has never been more important than in the austerity of recent years, when scrutiny of public spending has been at an all-time high.

The UK’s Medical Research Council (MRC) is committed to putting impact at the heart of our evaluation strategy to ensure we fund medical research that brings widespread health, societal and economic gains.

One of the ways in which we do this is through our economic impact funding program. This supports researchers in investigating the means of better understanding the links between medical research and its economic and societal impacts, and identifying ways to maximize those impacts.

Speeding up the time from lab to clinic

Professor Stephen Hanney at Brunel University London is one such researcher. He has been studying the ‘time lags’ and ‘elapsed time’ in medical research; what slows down or speeds up a healthcare intervention on its journey from lab to the clinic.

Pretty much everyone would agree that the speedy translation of research into medical advances such as new drugs, devices and healthcare policy is a good thing.

Aside from the health benefits, the economic return from an investment in medical research is higher the shorter the period of translation is. For example, in the area of cardiovascular disease, the rate of return on a new intervention doubles if you can reduce this period from 25 to 10 years.

Some elapsed time can also be beneficial; no one would argue against taking time to ensure that a new treatment is safe and effective.

However, the ways of measuring the time between research investment and resultant benefit are under-developed; and it is only with detailed analysis that we can understand what affects the length of this time, which parts of it are needed and how it can be reduced.

The life of a health intervention

With colleagues at RAND Europe, the Office of Health Economics, and King’s College London, Professor Hanney has built a matrix, representing the life of an intervention. Progress is marked by tracks, or stages, such as discovery research and policy development. Within these tracks are 11 calibration points, or milestones, to clearly measure when events occur, from the initial patents granted during the discovery stage, to the NICE guidelines being issued as part of the policy stage.

The team then applied this matrix to seven case studies in the areas of mental health and cardiovascular disease, measuring the time it takes to get from one track to another and looking for similarities between the time lags and elapsed time in individual case studies.

“The benefit of the matrix is that it allows for tracks to overlap and happen simultaneously. Also, it takes into account that progress might revert to a previous track, for example, conducting additional effectiveness research after the treatment has been launched,” Stephen explains.

Speeding up and slowing down – what are the causes?

In the case of treatment for schizophrenia, for example, advances in drug discovery meant that drug research became the focus, which slowed down progress in cognitive behavioral therapy.

There were instances where a time lag was a by-product of the area of research. In the case of treatment for schizophrenia, for example, advances in drug discovery meant that drug research became the focus, which slowed down progress in cognitive behavioral therapy.

The team also found examples of where the process was accelerated.

“In the case of the calcium channel blocker (CCB) amlodipine, a drug for high blood pressure, a post-launch trial showed that this treatment was more effective than a beta-blocker. This resulted in a more rapid updating of the NICE guideline on high blood pressure recommending CCBs as one of the first line treatments,” says Stephen.

So are there other means of reducing the time it takes to get interventions into standard practice?

Stephen and colleagues say that increasing resources, improving processes and researchers working in parallel would all help.

It is clear that the nature of time lags and elapsed time is complex. But a greater insight is a step towards narrowing the gap between bench and bedside — and another piece of the puzzle in understanding how to maximize the impact of research.

This study was the first of seven projects funded via the MRC economic impact program. The MRC is to hold a workshop in 2015 to showcase progress and define the next phase of the program.

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