The way that Neurology research outcomes are evaluated             poses challenge in progression from bench to bedside

By Gary D. Clark, M.D.

Objectify: 1 : to treat as an object or cause to have objective reality 2 : to give expression to (as an abstract notion, feeling, or ideal) in a form that can be experienced by others <it is the essence of the fairy tale to objectify differing facets of the child’s emotional experience – Merriam Webster Online Dictionary

One of the challenges that neurologists and developmental pediatricians face as we move the advances in the basic and translational laboratories to the research clinics will be to objectively measure outcomes in disorders such as Autism, Attention Deficit Disorder, and Cerebral Palsy.

	Are there ways to remove subjective measurements and biases from outcome measures in developmental disorders?

There have been many attempts to do this. Texas Children’s Hospital psychologists are able to quantify cognitive parameters, functional MRI can measure areas of the brain that are active in various disorders, Diffusion Tensor Imaging can show aberrant pathways in the brain and gait laboratories can measure movement abnormalities.

But do each of these measures apply to the core abnormalities or do they only correlate with the disease process? Are there ways to remove subjective measurements and biases from outcome measures in developmental disorders? Can studies be designed to examine parameters in a high throughput fashion utilizing the above techniques or some other, unforeseen measurement?

Measuring outcomes objectively
I am referring to “objectifying” outcome research as a means to be scientific, to avoid biases and to improve throughput in order to quickly capitalize upon research revolutions.

I realize that “objectifying” as used in the previous sentence is not the appropriate use of the word as it is defined in the Merriam Webster Online Dictionary, but I cannot yet come up with an English term that captures the concept of trying to take conditions often measured subjectively and measure these in objective, quantifiable and high throughput manners. Therefore, I intend to use this term for the above purpose, and I invite you to do the same. I also want to solicit your help and the help of our neighboring institutions of higher learning and industries to assist us in objectifying clinical research in the new Texas Children’s Hospital Neurological Research Institute.

Gary D. Clark, M.D., is chief of Neurology and Neurophysiology at Texas Children’s Hospital. He also is associate professor of Pediatrics, Neurology and Neuroscience, and chief of the Neurology and Developmental Neuroscience Department of Pediatrics at Baylor College of Medicine.

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