The Vanderbilt Institute for Clinical and Translational Research (VICTR) serves as an engine powering discovery across Vanderbilt Health’s research enterprise. By bringing together clinical care, scientific investigation, technology and collaboration, VICTR helps researchers turn promising ideas into breakthroughs that improve health and transform patient care.
Two VICTR leaders — Wesley Self, MD, MPH, Vanderbilt Health’s Senior Vice President for Clinical Research, and Jill Pulley, MBA, VICTR’s Executive Director — discuss how the institute accelerates innovation and delivers meaningful impact for patients, communities and the future of medicine.
What is clinical research? Why is it important to our community?
SELF: Some of the most prevalent diseases affecting people in Middle Tennessee today are diabetes, cancer, heart disease, obesity and mental health conditions. We all know people who live with these diseases, and the numbers seem to constantly rise. At VICTR, we work on each of these diseases individually, then bridge how Vanderbilt Health can improve lives with the information we glean from the research. Increasingly, we’re thinking about how to prevent these diseases before they even occur. For example, we are working on ways to prevent type 2 diabetes. We think about what biological mechanisms to target and then how to design what are most likely to be successful interventions.
PULLEY: We like to use the phrase, ‘We’re learning from what we do, and doing what we learn.’ Clinical care and research are a pair; you can’t do one without the other. We’re always looking for better solutions just as we always try to assess what are emerging as the biggest unmet medical needs. This is what academic medical centers should be doing.
I always hope that our clinical research enterprise is the place in Middle Tennessee and in our region where people come if something bad happens to you or your family. You know you have this reserve of expertise here.
Vanderbilt Health is one of the top 10 academic medical centers in the country when it comes to research grants awarded by the National Institutes of Health. Altogether the research portfolio, funded by the NIH and other sources, adds up to nearly $1 billion a year. How does this make a difference for patients and people living in the region?
PULLEY: Community impact means our ability to deliver access to ‘the latest.’ And the latest might come in the form of a clinical trial, or it might come in the form of physicians who are specially trained. The impact is not necessarily a drug — it can be a device, a behavioral intervention, or a surgical technique. Research provides access to investigational treatments that you wouldn’t have access to in other channels.
SELF: Everything that is affecting people in our region is within the research scope. A disease can never be too severe or too rare for us, or too common. We’ve set up systems so that scientists and doctors and nurses, and others in the health care communities, can carry out studies that really have impact by using the clinical research infrastructure we have built over time.
VICTR’s Drug Repurposing Program has identified promising new uses for existing medications, including a heart drug that may help prevent cancer from spreading. If these findings are so promising, why does it take so long to bring new treatments to patients?
SELF: We’re committed to giving our population the latest medicine. That doesn’t necessarily mean the most recently developed drugs. What it means is that care is influenced by the latest knowledge and up-to-date information, which sometimes means older drugs.
We have an obligation before we roll out new ideas in medicine to be sure they actually work and are safe. Early research findings are exciting, but they require rigorous research and clinical trials to ensure that patients receive care backed by strong evidence. This is the underlying principle of clinical research.
PULLEY: Science and high-caliber research are much more complex than many people realize. Vanderbilt Health has really smart investigators, some of the best in the world, and when a discovery shows promise, our researchers need to carefully design studies, recruit participants, collect and analyze data, and meet rigorous scientific and regulatory standards. At VICTR, we try to make that as efficient as we can possibly make it, but thorough research takes time because getting the answer right is most important.
Can artificial intelligence make it easier to evaluate new drugs and therapies and bring them to patients faster?
SELF: Artificial intelligence is a good example of new technology that is clearly going to impact medicine. Our job at Vanderbilt Health and VICTR is to make sure that it impacts medicine and people in positive ways. AI is only as good as the information it uses. It is our job to ensure that the data AI is using are accurate, and the conclusions are not based on faulty assumptions.
This is why human expertise remains essential. We’re thinking about how to set up a system of human checks and research, so we know what is good AI output and how to use it properly in medicine so that it enhances patient care. As with any other new technology we evaluate, we need to be really careful to ensure that the AI used in medicine is based on very solid evidence.
Wesley Self, MD, MPH, holds the Directorship in Emergency Care Research at Vanderbilt Health.
