Author Affiliations: Duke Translational Medicine Institute and the Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, North Carolina.
As the culture of medicine moves toward an evidence-based learning health system, high-quality research is needed to guide choices made by patients, physicians, administrators, and policy makers. However, the system responsible for generating that evidence in the United States is in crisis, as demonstrated by erosions of system efficiency,1 waning interest in clinical research among practitioners, and financial insolvency among participants in the clinical research enterprise.
Califf RM. Clinical Research Sites—The Underappreciated Component of the Clinical Research System. JAMA. 2009;302(18):2025-2027. doi:10.1001/jama.2009.1655