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Editorial
December 14, 2009

Bringing Better Treatments to Patients Faster by Expanding Access

Arch Ophthalmol. 2009;127(12):1674-1675. doi:10.1001/archophthalmol.2009.317

The clinical research process that takes a promising new treatment from initial investigation through Food and Drug Administration approval is well defined. How to quickly integrate that new treatment into physician practices remains a challenge. Failure to rapidly apply research results into practice costs society in terms of health and wealth. Inconsistencies between what is assumed to be best practices and what is actually happening in the community have been documented across medical specialties.1,2 Lenfant1 has shown that even the most straightforward interventions do not result in a speedy translation and that these delays negatively impact thousands of patients. A study sponsored by the National Institute of Neurological Disorders and Stroke (NINDS) evaluated 28 NINDS-sponsored trials conducted between 1980 and 2000 and estimated that during a 10-year period, the net benefit to society of applying trial results would be $15.2 billion.3 The potential public health impact of implementing findings from the Age-Related Eye Disease Study was estimated to be a reduction of 300 000 cases of advanced age-related macular degeneration and associated vision loss during a 5-year period.4 In 1985, the National Cancer Institute outlined an objective to reduce the US cancer mortality rate. They reported that, merely by widespread application of existing knowledge, mortality could be reduced by 25% to 50%.5 With this potential effect, it would seem prudent to find ways of speeding widespread clinical trial result implementation. Balas and Boren,6 however, reported that it takes an estimated average of 17 years to implement research results into practice.

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