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Clinical Investigation and JAMA

Thomas P. Stossel, MD
JAMA. 1987;258(22):3298. doi:10.1001/jama.1987.03400220098046.
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Modern medicine is an increasingly complex and troubled profession, but most will agree that science is at its heart. People know this and demand technical and scientific excellence as well as caring from their physicians. Consumers' wishes aside, the constant evaluation and reevaluation of the knowledge base in medicine—pathogenesis, diagnosis, and therapy—is a medical categorical imperative. Physical, biologic, and behavioral sciences underpin medicine, but the science that is unique to medicine is clinical investigation.

All kinds of research are needed. The fund of medical knowledge seems vast indeed, but the reservoir of ignorance is even greater. The revolutions of the past decade in molecular genetics, cell biology, neurobiology, and artificial intelligence are dazzling, and the opportunities to diminish this reservoir have never been better. The exploding possibilities, however, are constrained by limited resources, a limitation that is all the more frustrating because of the opportunities. Here, the practicing physician can


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