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r developing particular diseases. That information would then allow for personal health planning and medical interventions designed to prevent or detect disease in its earliest stages, when treatments can generally provide the maximum benefit. Such a model requires that medical treatment rely on solid evidence stemming from rigorous clinical investigation.

Despite the critical role for clinical research in advancing health care, several obstacles have prevented its expansion. "The 'parity gap' in peer-review funding is only a symptom of a larger, more complex problem," Snyderman said. The pool of well-trained clinical researchers remains inadequate as the medical community and the public at large continue to undervalue the role of clinical investigation in the advancement of health care, he continued.

Snyderman calls for academic medical leaders to "jump-start" support for clinical research by fostering clinical research centers within their institutions and by advocating the application of new discoveries and technologies to medical practice.

"The wave of the future for improving health care through evidence-based medicine depends on the capability of conducting large clinical trials," said Snyderman. "Clinical research is the way to translate the huge body of knowledge stemming from research into clinical practice. It is the way we will learn which medical interventions work and which do not in large patient populations over time."

Some medical centers have begun to focus on clinical investigation, Snyderman said. For example, the mission of the Duke Clinical Research Institute (DCRI) is to develop and share knowledge that improves the care of patients through clinical research. The DCRI has nearly 900 employees and has enrolled more than 450,000 participants worldwide in its clinical trials.

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Contact: Jeff Molter
molte001@mc.duke.edu
919-684-4148
Duke University Medical Center
17-Feb-2004

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