November 2006

Collaborative public‑private research

by Robert H. Blanks, PhD, President, RCS

Collaborative public‑private research is a major way that new innovations and technologies are brought to the marketplace.

In biomedicine, representatives of the private sector such as the insurance companies, pharmaceutical and surgical instrument companies, for‑profit hospitals, etc. all contribute to the massive technology machinery that is biomedicine.

The private sector is also very important in chiropractic creating significant infrastructure (insurance companies, instrument companies, colleges, peer‑reviewed journals, postgraduate seminars, etc.).

RCS is a private research company that cooperates with investigators at public institutions and chiropractors in private practice to collect, analyze and publish health outcomes data characterizing chiropractic. We are thus a hybrid organization that falls within collaborative public‑private research model.

Whereas most leaders in the profession understand the need for health outcomes data, evidence‑based chiropractic and quality control, there are still a few outspoken critics who continue to criticize any "privatization" of research.

In previous articles, I have addressed these critics who raised concerns because of the funding or ethical considerations. The most recent concern raised is the public support of RCS research by leaders in the field, i.e., a concern about blending private and public interests.

So, let's talk about the collaborative public‑private research model.

Research is not an integral part of the chiropractic culture, as it is in biomedicine and other fields. To better understand the importance and long‑standing tradition of the public‑private research model, one could look at the NIH, but it is actually easier to use the USDA as an example.

The United States Department of Agriculture (USDA) is one of the larger federal agencies initially established by President Abraham Lincoln in 1862. The agency has many responsibilities such as management of federal anti‑hunger programs (Food Stamp, School Lunch), stewardship of the U.S.'s 192 million acres of national forests, soil, land and water conservation and safety of meat, poultry and eggs.

However, chief among these charges is research leadership on everything from human nutrition to new crop technology for more food and fiber. To manage its mission and $93 billion dollar annual budget, USDA relies heavily on a subsidiary, the Current Research Information System (CRIS) to document and report all ongoing and recently completed research in agriculture, food and nutrition, and forestry.

Projects are conducted by USDA research agencies or through public‑private collaborative efforts contracted to state or other cooperating institutions, and through a number of USDA‑administered grant programs including Small Business Innovation Research (SBIR) and National Research Initiative (NRI) to the private sector.

Of a total $4.6 billion dollar budget this year, the USDA conducts 2,784 research internally at a cost of $1.3 billion, but oversees many times this in funding (14,594 projects; total annual cost $3.2 billion) to non‑federal agencies including the private sector.

By applying the public‑private collaboration research model, USDA researchers are spared the costly development work needed to prepare new technologies for commercialization in a time‑proven manner of working closely with the private sector. Private companies finance new technology and through a process of technology transfer can license this for general public use. USDA researchers can focus on research that benefits more people and in other areas.

Public‑private collaborations offer firms and research institutions valuable USDA information, either about a particular technology or line of development or else scientific expertise that differs from that of the private sector and academia.

Likewise, collaborations inform government scientists as to industry needs, and USDA also benefits through shared license fees and royalties.

Further, joint public‑private collaborative research helps reduce the costs to the developers and users of agricultural technologies.

Finally, a technology may provide large social benefits, but the investment required to commercialize the technology may exceed its return. In these cases, technology transfer by the government can offer the support necessary to explore research that has social benefits, but which may be risky, or may not have sufficient private returns.

At this point, it needs to be clearly stated that companies conducting collaborating private‑public research are outcomes‑based and intend to release and publish the information for public benefit.

This is in contrast to private sector companies doing market research (customer satisfaction surveys, purchase likelihood, attitudinal research, etc.) where the results are typically kept confidential, and are intended only for the use of the company that commissioned the research.

Keep in mind that marketing research is big business. Last year, the top 50 firms reported gross revenues from marketing research of $12.13 billion, according to the Council of American Surveys Research Organizations. But these companies are clearly outside the public‑private collaborative model.

The Japanese Ministry of Education, Culture, Sports, Science and Technology conducts an annual survey of research activities of private companies as one measure of the health of the economy (http://mext.go.jp/english/org/index.htm).

An important point made during the 1998 survey was "In order to encourage R&D systems of the nation as a whole including private companies to function and promote technological innovations and creation of new industries for economic restoration and maintenance of competitiveness, it is important not only to promote individual research activities of industry and the public sector, but also to pay attention to diversified factors for creating a smooth flow of knowledge and resources between these sectors."

The ready exchange of information exchange between the public and private sector is critical for success in biomedicine, but it seems to be slow to develop in chiropractic. The Japanese MEXT organization has recommended that the government get involved to encourage the private‑public exchange of information. We are also seeing this trend in the United States.

The NIH has embarked on an ambitious program to refocus the investments made during the past 15 years to help focus the research community and create a new model for medicine for the 21st century. This initiative, termed the NIH Roadmap, has three themes 1) new pathways to discovery, 2) research teams of the future, and 3) re‑engineering the clinical research enterprise.

What is important for chiropractic is that a significant part of the $28.6 billion dollar 2006 NIH budget will be redirected to focus on collaborative efforts including new pathways to discovery ($169 million) for creation of new technologies, databases and other resources, multidisciplinary research teams of the future ($44 million) for exploratory centers for interdisciplinary research, methods summit, research training, and interagency training. In addition, it will explore re‑engineering the clinical research enterprise ($120 million) to facilitate the rapid translation of discoveries from the laboratory to the clinic, train clinical investigators in new therapeutic and preventative strategies, and create clinical research networks employing a variety of clinical outcome measures (NIH, Summary of the FY 2006 President's Budget, Feb 7, 2005).

For chiropractic to be part of the new research venues, including the private‑public collaborative model used by USDA or the NIH Roadmap proposal, they need to organize, establish a unified research agenda and objectives, and create multiple mechanisms for carrying out these objectives.

RCS has created an important model for electronic data collection and analysis for publication if peer reviewed journals. To be successful, this model must have the cooperation of a large number of practitioners and their patients nationally and internationally. Other networks may need to spring up to advance the entire profession. Chiropractic is a large profession and it has a long way to go to establish a research culture and evidence‑basis. There is a lot of work to be done.

(RCS co‑founder and President Dr. Robert Blanks is Professor in the Department of Biomedical Sciences at Florida Atlantic University and a past Professor of Anatomy and Neurobiology at the University of California, Irvine. Prior to this he spent two years at the Max Planck Institute for Brain Research in Frankfurt, Germany and two years in the Department of Anatomy at Harvard Medical School. Dr. Blanks is on the Advisory Board of the International Spinal Health Institute, is a Board Member of the Council on Chiropractic Practice and is actively involved in chiropractic research. To learn more about health outcomes research and RCS, call 800‑909‑1354 or 480‑303‑1694.)