A well-characterized gap exists between establishing scientific evidence and integrating it into routine clinical practice. It often is noted that only a small proportion of scientific innovation is translated into routine clinical practice and that even then, the process can take more than a decade, according to a manuscript in the April 2024 issue of the journal Mayo Clinic Proceedings. Whereas this lag may vary by measurement approach, funding mechanism, and other factors, more recently published estimates indicate that it takes an average of 14 years and $2 billion to bring a new drug or medical device from conception to market. This research-to-practice gap has not historically been an important consideration in academic clinical research. The clinical research enterprise typically rewards the conduct of descriptive or mechanistic studies that are highly controlled. Although growing attention has focused on the need to accelerate translation of knowledge into clinical practice, protocolized intervention trials for evidence generation are often designed without appreciable attention paid to evidence translation and therefore do not lend themselves to integration of innovation into feasible and sustainable health care programs and policies in real-world settings. Integration of translational and implementation science principles and practices into clinical research can advance the translation of scientific innovation into improved patient care and population health.
The authors aim to prioritize and guide efforts to create greater efficiency and speed of scientific innovation across the translational science continuum to improve patient and population health. Key principles and practices rooted in translational and implementation science may be incorporated into clinical trials research, particularly pragmatic trials, to improve the relevance and impact of scientific innovation. Their thematic review intends to raise awareness on the value of translational and implementation science in clinical research and to encourage its use in designing and implementing clinical trials across the translational research continuum. These investigators describe the gap in translating research findings into clinical practice, introduce translational and implementation science, and describe the principles and practices from implementation science that can be used in clinical trial research across the translational continuum to inform clinical practice, improve population health impact, and address health care inequities.