July 23, 1999

Bedside research gets boost from new medical association

Bedside research gets boost from new medical association


Dr. David Robertson

The Association for Patient-Oriented Research (APOR) is a new medical research organization with close ties to Vanderbilt University Medical Center.

APOR was formed last year to support and promote patient-oriented research as a core discipline of the profession of medicine.

It has been recognized for some time that the number of clinical investigators is on the decline, threatening the vital link between the laboratory bench and the patient bedside, said Dr. David Robertson, professor of Medicine and director of the Clinical Research Center.

"There is now a consensus that clinical investigation was not supported by the NIH over the past 15 years the way it should have been," Robertson said. "Efforts are clearly underway to remedy that situation with the new K23 and K24 grants supporting young and mid-career clinical investigators and the K30 clinical curriculum award. But still there are problems in the infrastructure for clinical research, and the career ladders for clinical investigators at universities are not always well-developed."

To address those problems and support patient-oriented research as an entity, Robertson and a group of prominent clinical investigators, including Dr. John A. Oates, Thomas F. Frist Professor of Medicine, formed APOR.

Robertson is serving as the organization's first president.

APOR's objective is to establish ready communication among physicians and scientists engaged in patient-oriented research. As part of this objective, APOR will hold an annual meeting to bring clinical investigators together and feature new contributions to basic patient-oriented research. The association held its first annual meeting this year in May.

"We had a very good turnout – 131 attendees from North America, Europe, Africa, and Asia," Robertson said. "It was certainly a most distinguished group, and some very high quality science was presented."

APOR's membership ranks have already grown beyond 300. Individuals with M.D., Ph.D., and M.D./Ph.D. degrees who are involved in patient-oriented research are invited to join APOR.

"It is surprising to some people that Ph.D.s conduct patient-oriented research," Robertson said. "In fact, about every third year, the major user of our Clinical Research Center facilities at Vanderbilt is a Ph.D. rather than an M.D."

Patient-oriented research includes clinical pathophysiology – the study of how a body process works or the underlying nature of a disease – and clinical pharmacology – the study of how drugs alter human health.

"Patient-oriented investigators are people who test hypotheses in human subjects," Robertson said. "It's research where the physician and the patient are both in the room at the same time, and both are alive."

This close contact between patient and investigator distinguishes patient-oriented research from other clinical research like clinical trials, outcomes/health services research, and epidemiological studies.

"The great advantage of patient-oriented research is that so much about human beings is in the brain," Robertson said. "Rats just can't tell us how they feel, and patients can tell us so much. Nowhere will this be as critical as in the study of the brain."

In addition to Robertson and Oates, ten members of Vanderbilt's faculty are founding members of APOR.

"The founding members of this new society are calling to everyone in academic medicine to join them in future meetings. Their aim is to demonstrate that living, breathing patients are essential participants in the generation of important medical knowledge," wrote Dr. Jules Hirsch, Rockefeller University, in a perspective in the Annals of Internal Medicine. Hirsch will serve as the association's next president.

The Burroughs Wellcome Fund and the Robert Wood Johnson Foundation have provided financial support to APOR. To encourage student membership, APOR dues are waived for full-time medical and graduate students with an interest in patient-oriented research. For more information and to join, visit the APOR web site at http://www.mc.vanderbilt.edu/gcrc/apor.