Expectations for medical research vary sharply, depending on

the observer’s perspective.

For a patient affected by disease, it is a

source of hope.

For a parent of a child with a serious condition, it

evokes both expectation and frustration over the pace of progress.

Where a physician may seek a route to better care, an economist sees

an engine of growth and a politician sees high-skill jobs and improved

national competitiveness. Hospital executives expect research

to spawnnew services, whereas pharmaceutical CEOs must

havenewproducts. An insurance executive doubts instinctively that

the value of research will outweigh its incremental cost. A regulator

aims for the appropriate amount of risk while still getting innovations

that matter to the market. For philanthropists and public

health campaigners, research represents the best hope for alleviating

the world’s most immediate health-related problems. To a scientist,

research deepens critical knowledge and the way intelligence

and organized effort can improve health. All of these

constituents play a role in howresearch is funded and brought from

bench to bedside. Meeting their collective needs produces a complex

set of hurdles.

来源：JAMA. 2015;313(2):174-189.