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Commentary |

The Crisis in Clinical Research:  Endangering the Half-Century National Institutes of Health Consensus

Alan N. Schechter, MD
JAMA. 1998;280(16):1440-1442. doi:10.1001/jama.280.16.1440.
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Writing in THE JOURNAL in October 1952, Dr Norman H. Topping, associate director of the National Institutes of Health (NIH), announced the construction of the Clinical Center for medical research in Bethesda, Md, with these words:

Topping NH.The United States Public Health Service's Clinical Center for Medical Research. JAMA.1952;150:541-545.
Fredrickson DS.Biomedical science and the culture warp.In: Kelley WN, Osterweis M, Rubin E, eds. Emerging Policies for Biomedical Research: Health Policy Manual III . Washington, DC: Association of Academic Health Centers; 1993:1-42.
Bush V.Science, the Endless Frontier: A Report to the President on a Program for Postwar Scientific Research .Washington, DC: US Government Printing Office; 1945.
Wyngaarden JB.The clinical investigator as an endangered species. N Engl J Med.1979;301:1254-1259.
Gill GN.The end of the physician scientist. Am Scholar.1984;53:353-368.
Ahrens EH.The Crisis in Clinical Research: Overcoming Institutional Obstacles .New York, NY: Oxford University Press; 1992.
Kelley WN, Randolph MA.Careers in Clinical Research: Obstacles and Opportunities .Washington, DC: National Academy Press; 1994.
NIH Director's Panel on Clinical Research. NIH Director's Panel on Clinical Research Report to the Advisory Committee to the NIH Director, December 1997.Available at: http://www.nih.gov/news/crp/97report/ index.htm.
Nathan DG.for the National Institutes of Health Director's Panel on Clinical Research. Clinical research: perceptions, reality, and proposed solutions. JAMA.1998;280:1427-1431.
Thompson JN, Moskowitz J.Preventing the extinction of the clinical research ecosystem. JAMA.1997;278:241-245.
Shine KI.Some imperatives for clinical research. JAMA.1997;278:245-246.
Goldstein JL, Brown MS.The clinical investigator: bewitched, bothered and bewildered—but still beloved. J Clin Invest.1997;99:2803-2812.
Schrier RW.Ensuring the survival of the clinician-scientist. Acad Med.1997;72:589-594.
Shulman LE.Clinical research 1996: stirrings from the academic health centers. Acad Med.1996;71:362-363, 398.
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Williams GH, Wara DW, Carbone P.Funding for patient-oriented research: critical strain on a fundamental linchpin. JAMA.1997;278:227-231.
Gallin JI, Varmus H.Revitalization of the Warren G. Magnuson Clinical Center at the National Institutes of Health. Acad Med.1998;73:460-466.
Institute of Medicine. Scientific Opportunities and Public Needs .Washington, DC: National Academy Press; 1998. Available at: http://www.nap.edu/readingroom/books/nih. Accessed July 1998.

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