The 2009 feinberg lecture: The continuum of stroke research and policy

Background and Purpose-This annual Feinberg Award lecture is intended to present examples of the broad scope of stroke-related research and to show how different investigative approaches can advance the field to improve stroke patient's outcomes. In keeping with one of the objectives of the American Heart/American Stroke Association, this lecture also provides a perspective and highlights opportunities for beginning clinical investigators. SUMMARY OF REPORT-: Clinically, the continuum of stroke research and care can be divided into primary prevention, acute interventions, secondary prevention, and poststroke recovery. From a technical/methodological standpoint, fundamental laboratory studies yield insights into basic disease mechanisms and applied laboratory studies further explore the biological basis of disease and evaluate possible therapeutic interventions. The results of these laboratory-based observations can inform clinical study design whereas questions raised by clinical observations can be explored in laboratory experiments (ie, "translational" research). Additional information is gained through observational, interventional, and synthetic (eg, meta-analytic) clinical studies. Outcomes/effectiveness research determines how well interventions perform in different "real-world" settings. The discussion provides examples of how several of these approaches can be used to address various research questions. The importance for stroke investigators to contribute to related public policy issues is also reviewed. CONCLUSIONS-: This is an exciting era for clinical investigators studying stroke and for those at the beginning stages of their careers. Whether taking a broad-based research approach or working on a specific, focused question, our combined efforts are leading to improved outcomes for patients with stroke, the very goal of Bill Feinberg's career.