Mechanistic research closes the gap in knowledge gained from observational findings.

When you will get the February issue of Scottish Medical Journal in your hands, we will be in 2023 and recovered from our festive breaks and all set to face challenges of the world. Similar to expected and unexpected future challenges, one of the difficult issues in Medical Research has been lack of knowledge and understanding of mechanisms involved in disease processes and their differential responses to interventions. The February issue of SMJ reports a multi-institutional observational study of upper tract urothelial cancers (Figure) and confirms a higher rate of urinary bladder recurrences following ureteroscopic biopsy procedures. The paper further attempts to explore the mechanistic basis of this observation and showed clonal relatedness between upper tract urothelial cancers and urinary bladder recurrences. What is interesting about this study is the use of targeted next-generation sequencing of Colon and Lung Cancer Research Panel v2. Previous studies used MSK-IMPACT and in-house targeted sequences but concluded similar to us. The second important difference between previous studies and ours is the use of stained slides to extract tissue material (microdissection) as DNA resources.