Not only laboratory to clinic: the translational work of William S. C. Copeman in rheumatology
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Not only laboratory to clinic: the translational work of William S. C. Copeman in rheumatology Michael Worboys1 · Elizabeth Toon1
Received: 25 January 2019 / Accepted: 19 July 2020 © The Author(s) 2020
Abstract Since the arrival of Translational Medicine (TM), as both a term and movement in the late 1990s, it has been associated almost exclusively with attempts to accelerate the “translation” of research-laboratory findings to improve efficacy and outcomes in clinical practice (Krueger et al. in Hist Philos Life Sci 41:57, 2019). This framing privileges one source of change in medicine, that from benchto-bedside. In this article we dig into the history of translation research to identify and discuss three other types of translational work in medicine that can also reshape ideas, practices, institutions, behaviours, or all of these, to produce transformations in clinical effectiveness. These are: (1) making accessible state-of-the-art knowledge and best practice across the medical profession; (2) remodelling and creating institutions to better develop and make available specialist knowledge and practice; and (3) improving public and patient understandings of disease prevention, symptoms and treatments. We do so by examining the work of William S. C. Copeman, a dominant figure in British rheumatology from the 1930 through the late 1960s. Throughout his long career, Copeman blended approaches to “translation” in order to produce transformative change in clinical medicine, making his work an exemplar of our expanded notion of TM. Keywords Translation medicine · William Copeman · Rheumatology · Medical communication · Specialisation · Bench-to-bedside Abbreviations ARD Annals of the Rheumatic Diseases BMJ British Medical Journal * Michael Worboys [email protected] 1
Centre for the History of Science and Technology, University of Manchester, Manchester M13 9PL, UK
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M. Worboys, E. Toon
ERC Empire Rheumatism Council IRC International Congress Rheumatology JAMA Journal of the American Medical Association NA National Archives (Kew, London) WA Wellcome Archives
1 Introduction Since the arrival of Translational Medicine (TM) as both a term and movement in the late 1990s, it has been associated almost exclusively with attempts to accelerate the “translation” of research-laboratory discoveries into clinical applications (Krueger et al. 2019). Many discussions of TM assume a linear model, where “innovation starts with basic research, is followed by applied research and development, and ends with production and diffusion” (Godin 2006). One reason this model dominates is its applicability to pharmaceutical research and the goal of shortening, speeding up, or unblocking the “pipeline” of new chemical entities (NCEs) becoming approved drugs (Butler 2008). Observers and analysts have conventionally framed TM as a four stage process: T1—basic research to produce innovations with therapeutic potential, T2—development of clinical trials, T3—clinical implement
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