A Community Compass to Keep Basic Science on Track

By: Ana Emiliano, MD, MS, instructor in clinical investigation, Laboratory of Molecular Genetics, Rockefeller University

As an endocrinologist researching the basic science underlying obesity and type 2 diabetes, I wasn’t sure that participating in a community engagement project would lead me to greater insights into the molecular and genetic underpinnings of metabolic disorders. Because of our dichotomized medical training system, in which the basic sciences tend to be separate from the clinical sciences, I had embraced the misconception that clinical research was for epidemiologists and that I should stick to the lab. But the Rockefeller University-Clinical Directors Network community-engaged research team, which was convened as part of the community-engaged research navigation program described in a recent Academic Medicine article, is composed of so many smart and creative scientists that I couldn’t decline the invitation to partner with them on a project examining the metabolic outcomes of bariatric surgery in the New York University-Lutheran Family Health Center Network, in Brooklyn, NY.

My initial hope was to be able to correlate some of my findings from an animal model to human data, as my research involves performing bariatric surgery in mice. I had low expectations. However, as the project took off and meetings were held with clinicians at NYU-Lutheran, I was surprised to realize what great scientific partners these clinicians were. They included internists, primary care physicians, surgeons, psychologists, and social workers, all of whom had valuable insights into research questions that were clinically a priority, given their firsthand experience with patients’ struggles. And over the course of a few months, we became a unified research team, collectively assessing and vetting research questions. My fears that my “scientific views” would not be understood or valued were entirely unfounded. The difficulties we encountered in this collaboration ended up being related to logistical problems, including streamlining IRB approval processes, overcoming IT issues to ensure accurate data transmission, and training personnel for the adequate collection of biological specimens for research purposes.

The Bariatric Surgery Metabolic Outcomes Project (BMOP), which is how we named the project, has led to increased scientific productivity for all of us—we have shared and analyzed our preliminary findings with our clinical and community partners and presented our findings in poster presentations and talks at scientific conferences. Our first publication reporting bariatric surgery outcomes at 12 months is in the works, and we are now part of the scientific leadership of a national study examining metabolic outcomes one, three, and five years after bariatric surgery called the PCORnet Bariatric Study funded by the Patient-Centered Outcomes Research Institute. In addition, I have been able to correlate data from my mouse work, which is funded by an NIH early-career training grant (K08 from the National Institute of Diabetes and Digestive and Kidney Diseases), to patient data from BMOP.

The experience of working on this community-engaged project on bariatric surgery has significantly enriched my bench science. Instead of simply testing a hypothesis using a mouse model of bariatric surgery, I can now compare the findings from mouse experiments to human data from a community setting. For me, as a physician-scientist, there is nothing more important than being able to shape the basic science I perform in the lab into clinically relevant work that will lead to understanding and potentially overcoming human diseases, such as obesity and type 2 diabetes. I am definitely a better scientist because of how much I have learned through BMOP.

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