Understanding translational research: A play in four acts

Translational research (TR) bridges discovery to clinical delivery. All TR also requires the development of an intervention. Classical 'bench to bedside' TR is responsible for many important advances, but cannot account for many others,which beginwith clinical observations.Mypersonal involvement in TR has ranged fromexploration of long-termmechanical circulatory support devices to amelioration of the progression of Alzheimer's disease to the pharmacologic cure ofsmallpox. This experience suggests thatmost TR is opportunistic and inefficient. A strategic approach to TR based on a better understanding of the processes it entails could enhance progress in TR despite its increasing complexity.