There is a need to identify and develop suitable animal models (e.g. larger, non-primate animal models) that faithfully predict the outcomes of new medicines and treatments in heart, lung, blood, and sleep (HLBS) disorders prior to human clinical trials.

How might the NHLBI effectively encourage and support its investigators to collaborate with strategic partners to pursue the early translation of their HLBS discoveries into new diagnostics and therapeutics?

The critical challenges to effective early translation of discovery science experienced by the investigator community include:

1. The need for translational skills development, training and guidance

2. Need for... more »

There is a need to ensure that mentors have adequate skills, time, and incentives to mentor successfully.

Are we funding enough basic research to support future research?

Unless we fix and increase the R01 funding rate, which most basic scientists depend upon, we will continue to lose outstanding scientists of all ages and not have the next generation of scientists or the numbers of currently outstanding scientists to answer any of these compelling questions and critical challenges. Related to this, much has been written about the significant failure rate of clinical trials in part due... more »

NHLBI directed research should be abandoned and switched to investigator initiated research. I respectfully suggest read the following assay by Brown and Goldstein, Science 2012; 338: 1033-1034

The best way to run the science sponsored by the NIH (or NHLBI) is not to guide it (analogy to running science from ivory tower) but let the investigators decide what is worth pursuing. Get rid of NHLBI-directed research initiative... more »

Current costs for multicenter randomized or non randomized trials are astronomical, and a major obstacle to rapid implementation of potential lifesaving discoveries.
In the field of hematopoietic cell transplantation (HCT) their is a federal mandate to have a treatment outcome registry.
Funds should be made available to leverage that registry to perform prospective trials either randomized or not since HCT programs need... more »

The decision by NHLBI to not support the R21 mechanism may be stifling new and innovative research, partcularly by young investigators who do not have a track record of R01 funding. The critical challenge is to keep funding new ideas from younger investigators to keep their careers viable while they obtain the data and publications necessary for further R01-level funding.

Sleep and circadian disorders are relatively new areas of medicine. Most universities currently lack a critical mass of investigators to develop institutional T32 grants. Thus, there are, unfortunately, few such programs nationally. The Sleep Research Society has recognized this and is taking active steps to facilitate development of other T32 institutional training grants.

This will not, however, help the majority... more »

Translational research supporting stem cell therapy for cardiovascular disease, including: core laboratories for preclinical IND-enabling studies (e.g., PACT), and clinical trials networks for evaluating promising new treatments (e.g., CCTRN).

There is a need to identify effective interventions for heart, lung, blood, and sleep diseases that could have a transformative population level impact on health inequities if expanded at the national level.

There is a huge gap between basic science discoveries (some of which have no clinical application) and clinic practice (even when the basic science is related). Rarely do physicians, physician scientists, and basic scientists get together to answer a question that has public health or patient health impact. Without such an effort, a lot of taxpayer money is wasted on 'science for the sake of science' as well as in applied... more »

Over the last thirty years, our fundamental understanding of the genetics and pathogenesis of congenital heart disease has lagged the tremendous advances in the surgical and clinical care of infants with this group of disorders. We need to close this gap with investigation into the genetic basis of congenital heart malformations to develop new models of disease. The goall is translate an improved molecular genetic and... more »

A critical challenge is the need to bring together basic behavioral scientists interested in understanding human behavior at a fundamental level, including how and why people become motivated and capable of undertaking behavioral changes, with clinical researchers interested in developing and testing new strategies for tackling resistant behavioral problems such as obesity and non-adherence.

There is a need for more enhanced pain research in order to help improve sickle cell disease patient outcomes and quality of life.