Clinical Research: Hearing Before the Committee on Appropriations, U.S. Senate

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Mark O. Hatfield
DIANE Publishing, Jun 1, 1996 - 59 pages
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Presents the proceedings of a hearing on how much & how best to maximize the return of Federal investment in medical research. Includes testimony by representatives from the National Institutes of Health, Oregon Health Sciences Univ., Emory Univ., Brigham & Women's Hospital, Oregon Biotechnology Assoc., Amer. Fed. of Clinical Research, & PI Medical, Inc. Also includes discussions on loan repayment programs, collaboration with other agencies, governmentwide clinical research, clinical research panels, first awards, & the lack of young, trained clinical researchers.
 

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Page 9 - NIH-supported graduate and post-doctoral training programs to jobs in the industrial sector. The vitality of NIH research programs, therefore, has a direct impact on the strength of our Nation's industry, since the workforce in the pharmaceutical and biotechnology fields is trained to do science in the context of our training and research activities. ADVANCES IN MEDICAL RESEARCH THAT HAVE LED TO CHANGES IN CLINICAL PRACTICE To have an impact on improving health and combating disease, scientists need...
Page 7 - Today, that community numbers more than 50,000 investigators affiliated with nearly 2,000 universities, hospitals, and other research facilities located in all 50 states, the District of Columbia, Puerto Rico, Guam, the Virgin Islands, and certain points abroad.
Page 31 - Patients out there waiting for "the cure" must wait longer. • Second, the fruits of clinical research are often taken by industry and developed into new drugs, vaccines, or other health care products. These new products boost our economy and create jobs. • Third, while not all medical discoveries reduce health care costs, many do, as documented in NIH reports on the cost-savings resulting from new therapies.
Page 31 - American physicians are opting out of research careers for a variety of reasons, the most obvious of which is medical school tuition debt. A low-paying research fellowship is not an option for many indebted medical school graduates. The second problem only exacerbates the first, the loss of established investigators. Young physicians see their mentor struggling or see them abandon their research careers because of inadequate funding and they say, "Not for me.
Page 34 - The AMA reports that between 1985 and 1993, the number of physicians reporting research as a major professional activity fell from 23,268 to 14,716 - this occurring while the total number of physicians grew dramatically. This poses problems for the NIH extramural program as well. In 1970, physicians made up 43% of all principal investigators on funded grants.
Page 31 - And finally, the international implications of allowing clinical research to falter are enormous. We are beginning to see signs that other nations are picking up the clinical research banner that America is dropping.
Page 33 - In March of 1994, the Annals of Internal Medicine published an article by Yale Professor Edwin Cadman — "The Academic Physician-Investigator: A Crisis Not to be Ignored." — In September of 1994, the IOM published a report on the opportunities and challenges confronting clinical research. — Late last year, the journal Nature Medicine published a report documenting a slowing of medical discovery in the United States over the last several decades. — More recently, even the lay press has begun...
Page 34 - NIH extramural grant program as well. In 1970, physicians made up 43 percent of all principal investigators on funded grants. By 1987, this had dropped to 30 percent. Applications for NIH grants have grown dramatically in the past fifteen years, but most of the growth has been among Ph.D.'s.
Page 33 - AFCR has followed with great interest and enthusiasm your efforts to bring attention to the crisis that confronts our nation's clinical research effort culminating in the introduction in January of S. 1534 — the Clinical Research Enhancement Act. The problems confronting clinical researchers and their patients have received much attention but little action over recent decades: — In 1979, former National Institutes of Health (NIH) Director James Wyngaarden gave his seminal presentation characterizing...
Page 27 - ... highlight this career opportunity for many students who now have never seen or spoken to a clinical scientist in their entire medical school career. So I think in the last analysis, America still produces two commodities that are everywhere known to be the best: Jet airplanes and physicians, and I think we are about to be reduced to one best thing. Many forces are arrayed against our system of medicine: A declining NIH budget, even though it has currently been somewhat reversed, much thanks for...

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