Building sustainable IBD clinical research units: a practical toolbox emerging from a Belgian multi-stakeholder initiative.

Clinical research is an essential pillar of modern inflammatory bowel disease (IBD) care, underpinning therapeutic innovation, biomarker discovery, precision medicine, and improvements in healthcare delivery. However, while international initiatives have successfully defined standards for clinical care, comparatively little attention has been devoted to the infrastructure required to conduct high-quality clinical research. Consequently, research capacity remains highly heterogeneous across centers, limiting patient access to clinical studies and reducing opportunities for collaborative research. To address this gap, a Belgian multi-stakeholder initiative involving patients, gastroenterologists, research nurses, study coordinators, and clinical researchers developed a practical toolbox for establishing and strengthening IBD clinical research units. Rather than defining rigid accreditation criteria, the toolbox distinguishes between essential components required for a functional research unit and important but non-essential elements that further improve quality, efficiency, and long-term sustainability. Structured across 3 complementary domains (administrative, operational, and collaborative) this framework provides a pragmatic roadmap that can support centers at different stages of research maturity. Beyond describing the toolbox, we discuss the concept of research readiness as a hallmark of excellence in modern IBD care and propose a roadmap for building sustainable research ecosystems. Although developed within the Belgian healthcare system, the principles presented are broadly applicable and may support the development of research capacity across healthcare systems and disease areas.