Advances in imaging should be developed by interdisciplinary teams to facilitate efficiency in clinical studies and commercialization, according to National Institutes of Health Director Elias Zerhouni, MD.

Zerhouni noted that creating teams with scientists, doctors, engineers and physicists is only one step toward a more efficient process. In particular, scientists should have interdisciplinary skills and possess broad knowledge that will aid them in discovering new diagnostic modalities.

"We need to explore the pathways to discovery, we need to change the organization, [and] the way research teams are organized," Zerhouni stated Feb. 27 at the American Institute for Medical & Biological Engineering's (AIMBE) annual meeting in Washington, D.C. "There are tremendous amounts of interdisciplinary requirements there," Zerhouni said.

NIH began shifting to an interdisciplinary approach last year, when it announced that scientific programs would no longer be broken down by field, but rather divided into "discovery science," "applied science" and "interdisciplinary training" (¹ Also see "NIBIB Scientific Program Reorganization Reflects Multidisciplinary Research" - Medtech Insight, 27 January, 2003., p. 15).

At the time, Zerhouni highlighted interdisciplinary research as part of the ongoing NIH "roadmap." He reiterated the importance of the roadmap during the meeting.

"The reason we started the NIH roadmap is that we are in a transition phase in science. With the progress that we've made in the past ten years, we're facing problems that we didn't face before," Zerhouni said, referring to a shift in emphasis from acute, short-term conditions to chronic diseases over the last 35 years.

"When you look at current expenditures in healthcare, 75% are related to chronic [diseases]," he observed. "That has profound implications on how we do research." Zerhouni stressed that NIH needs "a rigorous way of self-examining our research and the direction of the research."

The NIH roadmap will focus training and research efforts on chronic diseases and will aid the agency in becoming more economically efficient.

Specifically, further imaging research is expected to lead to a better understanding of the underlying biological systems and, in turn, earlier disease detection.

"We need to understand quantitatively - not qualitatively - how these pathways are integrated, because you can't intervene in a complex system unless you have some understanding of the subsystems in the context of their environment," Zerhouni stated.

The NIH director argued that the complexity of biological systems exceeds that of rocket engines, and consequently, industry and academia need to accelerate the pace of discoveries.

"We need to have a system of research that encourages the central fact that it is our understanding of biological systems that will allow us to predictably influence the emergence" of new diseases and treatments, Zerhouni asserted.

Developing better imaging systems could lead to earlier disease detection, which would dramatically cut healthcare costs, according to Zerhouni.

"If you continue to practice medicine the way we've practiced it in the paradigm of the past, where we've waited for diseases to create loss of function before we intervene, we'll realize that costs are out of control."

If healthcare spending goes unchecked, "it will start eating into every discretionary fund the government has and at some point there is a level that is not sustainable," Zerhouni predicted.

The NIH director also expressed a desire to develop non-destructive imaging modalities as a means to discover diseases earlier and more efficiently.

Current imaging "is not going to be able to give us the dynamic information [and] temporal resolution needed," he said. "We need to evolve from destructive to non-destructive" imaging. Such imaging systems would be able to spatially localize information.

The National Institute of Biomedical Imaging & Bioengineering, which received $289 mil. in 2004 funding, has requested $298 mil. for 2005. The total NIH budget is $28 bil.

Interdisciplinary Teams Focused On Imaging Research Needed – NIH Director

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