Our Mission is Translation

The BIH establishes coordinated structures in one place and thus creates a translational ecosystem. Such an approach enables the various professional groups involved to use their expertise to establish new preventive strategies, develop new diagnostics and effective therapies, and to discover how these options can be effective for patients. The BIH ecosystem bundles a variety of competencies and infrastructures in the vicinity of the Charité clinical facilities, confirming the findings that:

• translational processes are usually not linear, as suggested by the concept of the translational value chain; and
• a variety of skills, infrastructures and support mechanisms are essential for effective translation

As such, this environment allows continuous optimization of ideas and solutions in one iterative ‘bench to bedside’ and ‘bedside to bench’ process. Crucial for the achievement of the BIH mission is the continuous development of the ecosystem as a learning system.

The BIH focuses on cross-cutting issues: for example, digital medicine, and cell-based therapies as innovative drivers and enablers; and not organ-specific approaches such as cardiology and cancer research. The BIH, thus, works across systems medicine, examining processes that arise from the interaction of various organs and systems in the body. The systems medicine translation approach at the BIH is therefore a necessary addition to the disciplinarily oriented approach of the German Centers for Health Research, which uses a decentralized network of expertise at several locations, with each focusing on widespread diseases.

A major reason for this decline is the complexity of the steps required along the translational value chain, from innovative idea to real-world clinical application. In addition, a multitude of infrastructures and technologies, as well as professional groups with different skill sets, are required to contribute to the process and work towards a common goal.

Another challenge lies in the combinations of people involved in these various stages, who often have different priorities, speak different languages ​​and work in different communities. Translation cannot, and should not, be divided into ‘basic scientific knowledge’ and ‘implementation in clinical practice’. On the contrary, translation-oriented teams and facilities must both be anchored in the clinic, and in the laboratory. The necessary ‘mindset’ for translation can only arise within this context.

Another challenge for medical translation is the pathophysiological limits of traditional, organ-oriented, concepts in medicine and research. These promote a deep understanding of individual structures, but do not take sufficient account of the fact that the different functions and structures within an organism are closely linked; physiological and pathological mechanisms overlap, and genetics and the environment affect all organs and systems simultaneously. 

Specific indicators must focus on the BIH mission, i.e. reflect the relevant medical benefits for patients.

• Introduction of new preventive, diagnostic and therapeutic procedures into the clinic
• Products and launches
• Changes to guidelines, treatment and therapy guidelines
• Returns from sales and licensing
• Social added value (virtual proceeds)
• PROMS (Patient Reported Outcome Measures)

These direct indicators only emerge at the end of the successful translation and, therefore, with a considerable delay in the important preparatory steps. However, these contributions are indispensable and can also be measured at short notice. They also need to be assessed and incentivized:

• Proof of principle studies
• Manufacturing permits, etc.
• First in human - studies and clinical studies based on own concepts (IIT)
• Ratio: from number of patents or patent applications to patents being used
• Licensing, spin-offs and corresponding cooperation

Also relevant for the BIH strategy are additional parameters that assess quality and sustainability at all levels of translation, such as:

• Open Access publications
• Open Data/Open Science
• Publication of negative results
• Confirmatory Studies