Published: 02 February 2022
Professor Danny McAuley, Director of the Efficacy and Mechanism Evaluation (EME) Programme, writes about how the role of translational research in the journey from scientific discovery through to directly benefiting patients is more visible than ever following the COVID-19 pandemic and how EME is playing a crucial role.
The COVID-19 pandemic has highlighted the importance of a healthcare research system which can support the rapid and seamless development, testing and comparison of new technologies and treatments. Translational research - the journey of ideas and discoveries to medicines and interventions that benefit patients is often described as spanning from ‘bench to bedside’. COVID-19 has highlighted how it is possible to speed up this pathway, while still providing robust evidence to ensure treatments and technologies are safe and effective for clinical use.
Leading the way
The Efficacy and Mechanism Evaluation (EME) Programme - a Medical Research Council (MRC) and NIHR partnership – plays a key role in the UK translational funding landscape. By supporting research which evaluates whether a technology truly benefits patients’ health, the Programme can facilitate the translation of novel technologies and the repurposing of existing interventions to be used for more patient groups. EME studies can also demonstrate that a technology doesn’t have the desired effect and so help researchers to focus on other promising approaches.
There are some big challenges which this community faces, such as the recovery of research activity which was paused or delayed by the pandemic, as well as recognising the need to address emerging and future health and social care needs. However, the UK has a thriving life sciences industry with world-leading expertise in many areas and the NIHR, with UK Research and Innovation (UKRI), is leading the way in supporting this type of research.
A recent independent report has highlighted just how crucial the EME Programme is in ‘filling the gap’ and bridging the space between proof-of-concept research – which provides early evidence if a treatment is safe and likely to be successful - and effectiveness studies – which measure the benefit of a treatment in real-world healthcare settings.
Since the programme was set up, 75 EME studies have published their findings in the EME journal, covering a wide range of technologies and health conditions. Case studies included in the report span a novel gene therapy for cystic fibrosis; repurposing of a cancer drug for diabetic retinopathy; a medical imaging technique for targeting radiotherapy; optimisation of nutrition for preterm infants and a ‘platform trial’ to evaluate multiple possible treatments for specific types of colorectal cancer.
The 10 year evaluation report recognises how our position is unique, with limited overlap or duplication with other funders, given that EME supports large, multi-centre efficacy trials able to rigorously evaluate the efficacy of interventions, whilst also supporting work to improve our understanding of the underlying mechanisms of action. Study teams can undertake this mechanistic work within the same project, or using patients, data and samples from other studies. Through this further understanding, the studies we fund can lead to improved use of treatments and may inform future development.
The Programme provides a valuable foundation for close working between UKRI, through the MRC, and the NIHR, which is important for maximising this flow of research. Since it was formed to ‘fill the gap’, I’m proud to see how EME has helped vastly improve the funding landscape for translational research in its capacity to support UK strengths in innovation and development, over the last decade. But there’s more we can do.
Looking forward, we need to draw on the recommendations of the report and build on its successes, to ensure we help the research community to meet the challenges of the future.
Key solutions include enabling researchers to propose innovative, ambitious and more efficient trial designs; supporting early career researchers in EME studies, to build translational research capacity; and commissioning in areas which encourage multi-disciplinary and cross-sector collaborations.
We are also working to help researchers navigate this landscape by improving the links and signposting between EME and funders which support proof-of-concept studies. A key goal is to providing clarity around the continuum of funding that is available.
One area we are already making strides in is renewing our communication of the research EME supports by combining the funding opportunities for efficacy studies and mechanistic work under one remit-spanning Researcher-led call. This call re-emphasises EME's commitment to supporting both efficacy trials and mechanistic insight within clinical trials, whether individually or combined.
As a programme we will ensure we continue to evolve to address the recommendations from the report to maintain and develop our unique role to deliver health benefits.
Professor Danny McAuley, Director of the Efficacy and Mechanism Evaluation (EME) Programme
Apply to the EME Researcher-led call.
Read the EME 10 Year evaluation report in the NIHR Journals Library.
(This report complements the MRC Translational Research 2008-2018 and the Biomedical Catalyst Impact Evaluation reports which also began exploring the increasingly complex translational research landscape)