Juffermans Nicole P, Radermacher Peter, Laffey John G
Laboratory of Experimental Intensive Care and Anesthesiology, AmsterdamUMC, location AMC, Amsterdam, the Netherlands.
OLVG Hospital, Amsterdam, the Netherlands.
Intensive Care Med Exp. 2020 May 26;8(1):17. doi: 10.1186/s40635-020-00304-4.
Discovery science, a term which encompasses basic, translational, and computational science with the aim to discover new therapies, has advanced critical care. By combining knowledge on inflammatory and genomic pathways with computational methods, discovery science is currently enabling us to optimize clinical trials design by predictive enrichment and to move into the era of personalized medicine for complex syndromes such as sepsis and ARDS. Whereas computational methods are gaining in interest, efforts to invest in basic and translational science in critical care are declining. As basic and translational science is essential to advance our understanding of the pathophysiology of organ failure, this loss of interest may result in failure to discover new therapies for the critically ill. A renewed emphasis on basic and translational science is essential to find solutions for fundamental questions that remain in critical care. This requires a strategy to prioritize basic and translational science as an essential component within the critical care research "toolkit." Key aspects of this strategy include an increased focus on basic science in critical care medical curricula as well as in critical care platforms such as conferences and medical journals. Training of critical care clinician scientists in basic and translational research will require new organizational models within the academic institutions, as well as the development of new funding opportunities for early career critical care clinician scientists.
探索性科学，这一涵盖基础科学、转化科学和计算科学以发现新疗法为目标的术语，推动了重症医学的发展。通过将炎症和基因组学途径的知识与计算方法相结合，探索性科学目前使我们能够通过预测性富集优化临床试验设计，并迈入针对脓毒症和急性呼吸窘迫综合征等复杂综合征的个性化医疗时代。尽管计算方法越来越受到关注，但重症医学领域对基础科学和转化科学的投入却在减少。由于基础科学和转化科学对于增进我们对器官衰竭病理生理学的理解至关重要，这种兴趣的丧失可能导致无法为重症患者发现新的治疗方法。重新重视基础科学和转化科学对于解决重症医学中仍然存在的基本问题至关重要。这需要一种策略，将基础科学和转化科学作为重症医学研究“工具包”中的重要组成部分进行优先排序。该策略的关键方面包括在重症医学课程以及诸如会议和医学期刊等重症医学平台上更加关注基础科学。在学术机构内部，对重症医学临床科学家进行基础和转化研究的培训将需要新的组织模式，同时还需要为早期职业重症医学临床科学家开发新的资金机会。
