DFG Senate Commission approves recommendations for developing clinical research at German universities

At the annual meeting of the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) on 30 June 2015, the Senate of the largest research funding organisation approved recommendations for "Developing Clinical Research at German Universities Between 2015 and 2025" (available in German). The DFG Permanent Senate Commission on Key Questions in Clinical Research, chaired by DFG Vice-President Professor Dr. Leena Bruckner-Tuderman, had presented this abstract. "We can see an urgent need for action in various fields in order to keep university medical centres able to perform their role in patient-related, disease-related and fundamental research and in the highest level of teaching and patient care," explained Bruckner-Tuderman. In the paper, the Senate Commission recommends dependable career paths in clinical research and modern staff management. From the Senate Commission's perspective, special priority should be given to targeted long-term investments in urgently required infrastructures and the staff associated with this, in particular in clinical trials, personalised medicine, new bioinformatics methods and generally speaking for archiving and utilising materials and data. "University medical centres are currently facing exceptional challenges when it comes to research and structure, which are addressed in the paper with these extensive strategic and funding-policy recommendations," said Bruckner-Tuderman in summary when the recommendation was published.

"The innovation process in clinical research only occurs when insights from clinical work and research are being directly exchanged. This process typifies good university hospitals, which are the only places where this level of quality can be accomplished," said DFG President Professor Peter Strohschneider when demonstrating the potential of clinical research in Germany in the foreword of the recommendations. The Senate Commission considers substantial investments in technology and staff to be vital in order to maintain and expand upon this. The Senate Commission also stated that the important instrument of clinical trials must be diversified and broadened. "We need scope for research that is clearly depicted as part of the overall role of university hospitals and dependable career paths that attract the next generation of medical staff to research at an early stage and keep them in this role," emphasised Bruckner-Tuderman, who also referred to the recommendations concerning "Clinician Scientists" published by the DFG Senate Commission in April 2015.

The reason why the DFG is once again focusing on clinical research relates to many deficits that the Senate Commission names in the paper, which states that the structures are not future-proof, career prospects for research physicians are insufficient and there is also not enough scope for academic work in clinical practice. Stagnating budgets, a lack of funding for university construction, the increasing focus on the revenue generated by university hospitals in times of diagnosis-related groups (DRG) and the positive discrimination of doctors who do not conduct research through the corresponding wage agreements result in university hospitals lagging considerably when it comes to research structures. The DFG therefore views the recently rescinded ban on cooperation in joint research funding matters of federal government and the German Länder as an important opportunity to radically improve the described situation.

In light of this, the DFG also advocates open-topic and free competition for funding. In addition, the DFG believes that state funding for select areas of clinical research within defined topical and organisational limits is insufficient on its own and requires redirection. "Our main focus is on knowledge-driven and open-topic project funding in independent competitive procedures," said Bruckner-Tuderman.

Modern medical research at the universities has been shaped by considerable achievements in basic research. An increasing amount of information is available for developing more precise and personalised diagnoses and treatments. However, the data must be traceable and evaluable. This constitutes an essential requirement for understanding the underlying biological functions - from gene and protein levels to the entire organism - and for comprehending their relevance, both for the individual or defined patient bases and cohorts. Suitable assistance systems that make the complexity of modern research data manageable for the people involved are also required for this. However, as emphasised in the recommendations, it will be crucial for university hospitals to succeed in continuing to train and retain well-educated clinical staff with an intrinsic interest in and reliable understanding of research.