Shaywitz D A, Martin J B, Ausiello D A
Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA.
Am J Med. 2000 Aug 1;109(2):136-40. doi: 10.1016/s0002-9343(00)00452-6.
Remarkable advances in modern biology have enhanced our understanding of disease, permitting us to define-and potentially to treat-illness at the cellular and molecular level. The challenge we now face as physicians and physician-scientists is ensuring that these advances find expression in clinical practice. Thus far, the distance from the bench to the bedside has been surprisingly difficult to span, reflecting the need to develop broader, more integrative approaches to understanding how component molecules and physiologic systems function in the context of the whole person. Although there appears to be a consensus about the need to pursue such integrative, patient-oriented research, a mechanism for training future investigators in this discipline is less well established. In this essay, we present and develop the rationale for a set of underlying principles for patient-oriented research that can be used to guide appropriate training in this field. We also describe briefly a recently established prototype program-the Harvard initiative in Patient-Associated Science: Training, Education, Understanding, and Research (PASTEUR)-that we hope will help cultivate patient-oriented investigators and catalyze the evolution of patient-oriented research into a fully realized academic discipline.
现代生物学的显著进展加深了我们对疾病的理解，使我们能够在细胞和分子水平上定义并有可能治疗疾病。作为医生和医学科学家，我们目前面临的挑战是确保这些进展在临床实践中得以体现。到目前为止，从实验室到临床的距离出人意料地难以跨越，这反映出需要开发更广泛、更综合的方法来理解组成分子和生理系统在整个人体背景下是如何发挥作用的。尽管对于开展这种以患者为导向的综合研究达成了共识，但针对该学科未来研究人员的培训机制却尚未完善。在本文中，我们提出并阐述了一套以患者为导向的研究基本原则的理论依据，这些原则可用于指导该领域的适当培训。我们还简要介绍了一个最近设立的原型项目——哈佛患者相关科学倡议：培训、教育、理解与研究（PASTEUR），我们希望它将有助于培养以患者为导向的研究人员，并推动以患者为导向的研究发展成为一门成熟的学科。
