Pardon the pun in the title, especially since we also have a deep bench when it comes to bench research. But as this new year kicks off and because so much of its focus will be on the coming union with Mercy Iowa City, I wanted to point to an area of the department’s strength that does not always grab the most headlines but always deserves them. In fact, not only does our clinical research consistently deliver breakthrough therapeutics and diagnostics for perplexing conditions, but our investigators at Iowa regularly discover ways to keep our patients and their providers safer. I have asked a few of our clinical researchers to describe their varied work and what makes Iowa a great location for success. It should also be understood that the limited space I have here prevents me from covering all of our highly productive and successful clinical scientists in the department.

When one thinks of clinical research, one naturally first thinks of the clinical trial, and this is both a long-standing strength of our department and an area in which we continue to innovate and lead, particularly in Phase I trials in oncology. Associate Professor Dr. Yousef Zakharia tells me that at any given time in the Holden Comprehensive Cancer Center there are between 15 and 20 Phase I trials running, a stunning number, with many more in the pipeline. As many as 120 patients every year are participating in cutting-edge research and gaining access to literally the most novel therapeutics possible. Often, he says, most of these patients have no other treatment options. Less than five years ago, those numbers were much smaller, with as few as five new trials launching in a year. But under Dr. Zakharia’s guidance, a team of expert and dedicated personnel found ways to safely and efficiently speed up the approvals and maintenance processes of new trials. That team continues to grow and to refine its methods, bringing more hope to more people facing nearly impossible odds.

The link between clinical research and patient outcomes may be clearest in clinical trials, but the work being done in health services research and development (HSR&D) in our department is just as crucial in outcomes. Our department has developed a world-class reputation for HSR&D at Iowa thanks in no small part to our Associate Chair for Clinical and Health Services Research Dr. Eli Perencevich. He says our department has “a critical mass of health services researchers.” And just as with the cancer center’s Phase 1 clinical trials team, the abundance of researchers means shared support resources produce greater efficiency and a higher likelihood of collaborative creativity. “Data scientists, data managers, and qualitative analysts can work on multiple projects” simultaneously, bringing their expertise to the individual researcher’s project. Dr. Perencevich points to the existence of these core teams both within CADRE, the VA-designated Center for Innovation, and also in the Institute for Clinical and Translational Science (ICTS).

A member of that “critical mass” of HSR&D researchers, Associate Professor Dr. Michi Goto, agrees that the collaboration here is helpful but that it is not just within the College of Medicine or at the Iowa City VA, stretching across the Iowa River as well. He points to ongoing projects with faculty members and the mentoring of graduate students within UI’s College of Liberal Arts and in the Tippie College of Business. Moreover, research collaborations have extended around the world to Switzerland, the Netherlands, Spain, Japan, Taiwan, Canada, and Saudi Arabia, just in the last 10 years. Truly, Iowa’s reputation for health services research is a global phenomenon.

Dr. Michelle Mengeling focuses on the disparities of health care access between rural and urban areas. Four of her currently funded grants, she says, “benefited from our known rural expertise.” She says that Iowa’s decision to make studying and improving rural health a priority has attracted researchers interested in that area to Iowa. Iowa City is now a part of a VA-funded Evidence-based Evaluation Center partnering with researchers in Charleston, South Carolina, and Providence, Rhode Island. She also cites the already-rare Advanced Fellowship in Health Services Research that she co-directs at Iowa, which ours is even rarer for its focus on rural health and a “thriving cohort” of health services researchers for mentorship.

Associate Professor Dr. Diana Jalal sports a robust translational clinical research program focused on identifying novel pathways and therapeutic targets to modulate inflammation and improve vascular function in patients with chronic kidney disease (CKD). Her team is funded by both the NIH and the American Heart Association to evaluate the potential role of the alternative complement pathway in cardiovascular disease in those with CKD. She utilizes an array of translational tools to conduct this patient-based research and hopes that such work will lead to treatments that would improve outcomes in patients with CKD.

Dr. Jalal also notes that when came to Iowa she was not a health services researcher but, she says, she had some knowledge of clinical operations and had done some work in quality improvement. After getting to know just how extensive the support infrastructure was here, the possibilities began to appear. She cites a VA-funded mixed methods study in which she is evaluating whether self-management of high blood pressure is effective at improving blood pressure control in Veterans with CKD. This study became a reality once she connected with well-established experts in implementation science like Dr. Korey Kennelty in Pharmacy and Dr. Heather Reisinger in General Internal Medicine. There is much, much more to be said at this link about Dr. Reisinger’s contributions to research here and about the many researchers in our department working in implementation science.

What becomes quite plain is that the traditional models of academic medical research, while still very much supported and in practice here, are not the only way to advance our understanding of how to care for patients or how to deliver health care in general. The more we embrace collaborative and creative models for discovery, the easier it becomes for the next good idea to emerge. I am proud of the ground we have already plowed, the seeds already planted, and look forward to what crops up next.