Why Is Revitalizing Clinical Research So Important, Yet So Difficult?

The authors believe that support for academic clinical research has greatly declined in recent decades. Here the authors discuss our views on why this has happened. They define clinical or patient-oriented research as limited to the study of human beings or populations of individuals, and argue that its eclipse in favor of basic and translational research is the result of inappropriate conceptual paradigms or models for medical advances. The authors believe that medical history shows that the b3sbench-to-bedsideb4s model is inadequate to explain most recent progress and that clinical advances themselves often lead to new basic research. Discussion of alternate conceptual frameworks for biomedical research should help lead to changes in funding and organizational structures that might finally revitalize clinical research.