Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorJody W.ZylkeMD, Contributing EditorIndividualAuthor
To the Editor: I was disappointed that the JAMA
theme issue on opportunities for medical research gave no attention to the
need to develop research in primary care. Rather, the issue centered almost
entirely on biomedical research. While such endeavors are very worthwhile,
research that will help improve the processes of care is equally important.
For instance, Dr Michaud and colleagues1
described the DALYs in the United States in 1996. I note that the detection
and management of most of these diseases (which often coexist) are within
the realm of community primary care. Even "congenital abnormalities" are responsive,
to some extent, to prepregnancy and prenatal interventions in the primary
care setting. Another example is ischemic heart disease; it is clear that
much remains to be done to identify patients at risk at a time when primary
prevention is effective. It is similarly important to develop efficient ways
to identify such patients that can be incorporated into day-to-day practice
and that are acceptable to patients—who often may have multiple other
medical problems. Another example is alcoholism. There needs to be as much
emphasis on early detection and intervention2
as on advances in transplantation technology.
Beasley JW. Medical Research in the 21st Century. JAMA. 2001;286(15):1833–1835. doi:10.1001/jama.286.15.1833
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