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ARTICLE |

Some Imperatives for Clinical Research FREE

Kenneth I. Shine, MD
[+] Author Affiliations

Reprints: Kenneth I. Shine, MD, Institute of Medicine, National Academy of Sciences, 2101 Constitution Ave NW, Washington, DC 20418.


JAMA. 1997;278(3):245-246. doi:10.1001/jama.1997.03550030085040
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The preeminence of the research university in the United States is based on a policy to support basic science research, research training, and education in the same institution. The success of American medicine, and particularly of its academic health centers, is the result of this combination accompanied by a strong commitment to apply basic research through clinical studies performed during clinical care. America's leadership in health research and health care may be in serious jeopardy because opportunities for clinical research are at significant risk. Between $800 million and $2.5 billion from patient care revenues have been used to underwrite research in our academic health centers.1,2 Attempts to control expenditures through managed care and reductions in Medicare and Medicaid place increasing pressure on the budgets of these institutions and threaten this source of research support. Studies by the staff at the Association of American Medical Colleges have shown that "medical

REFERENCES

Jones RF, Sanderson S.  Clinical revenues used to support the academic mission of medical schools, 1992-1993 . Acad Med . 1995;;71:300-307.
Shine KI.  Continuous innovation in health . Science . 1997;;275:9.
Association of American Medical Colleges. The Financing of Medical Schools: A Report of the AAMC Task Force on Medical School Financing . Washington, DC: Association of American Medical Colleges; 1996;:34-35.
Institute of Medicine; Kelley WN, Randolph MA, eds. Careers in Clinical Research: Obstacles and Opportunities . Washington, DC: National Academy Press; 1994;.
Shine KI.  Continuing innovations for health . FASEB J . 1997;;11:398-403.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

Jones RF, Sanderson S.  Clinical revenues used to support the academic mission of medical schools, 1992-1993 . Acad Med . 1995;;71:300-307.
Shine KI.  Continuous innovation in health . Science . 1997;;275:9.
Association of American Medical Colleges. The Financing of Medical Schools: A Report of the AAMC Task Force on Medical School Financing . Washington, DC: Association of American Medical Colleges; 1996;:34-35.
Institute of Medicine; Kelley WN, Randolph MA, eds. Careers in Clinical Research: Obstacles and Opportunities . Washington, DC: National Academy Press; 1994;.
Shine KI.  Continuing innovations for health . FASEB J . 1997;;11:398-403.
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To understand the clinical management of acute heart failure syndromes.
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