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Commentary
October 28, 1998

The Crisis in Clinical ResearchEndangering the Half-Century National Institutes of Health Consensus

JAMA. 1998;280(16):1440-1442. doi:10.1001/jama.280.16.1440

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:

As far as research in our own laboratories is concerned, we have concentrated almost exclusively on basic laboratory research. This work covers virtually every discipline related to medicine. . . . The great gap in this research program has been in clinical research. We have been hampered for a number of years by inability to carry our laboratory findings through to clinical evaluation. We have also been hampered to an unknown but important degree by the absence of the stimulus that clinical research offers to laboratory research. . . . The Clinical Center will provide a means for bringing together in constant intellectual and physical contact outstanding practitioners in virtually all the clinical and laboratory specialties. This will be done in the presence of that most powerful inciter of creative thought—the sick human being for whom the vast potentialities of medical science have not yet been realized.1

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