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Comment & Response
January 17, 2017

Underperforming Big Ideas in Biomedical Research

Author Affiliations
  • 1Department of Pediatrics, University of Washington, Seattle
  • 2School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston
JAMA. 2017;317(3):321-322. doi:10.1001/jama.2016.19997

To the Editor In a Viewpoint, Dr Joyner and colleagues1 claimed that decades of research spending has been misguided by focusing on big ideas such as personalized medicine, stem cell therapy, and electronic health records (EHRs). Their definition of personalized medicine relied on 6 themes proposed by Collins2 that attempted to predict the value of focusing on genetics and subcellular biology at the start of the Human Genome Project in 1999. Although we agree that progress in subcellular biology (especially genetics) and health information technology (especially EHRs) has not yet achieved the anticipated promise, we believe that it is too early to judge the success or failure of these 8 big ideas on the basis of whether they have achieved “measurable reductions in mortality and morbidity.” If one were to judge all biological or information technology–related research using these criteria, researchers would be limited to studying ways to increase adoption of known public health interventions including: getting the general population to eat less and exercise more; reducing the incidence of drunk driving; increasing the use of seat belts, child restraints, and bicycle helmets; and reducing cardiovascular disease risk through aspirin, blood pressure control, cholesterol reduction, and smoking cessation.

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