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April 1989

Advances in Neonatal Care-Reply

Am J Dis Child. 1989;143(4):441. doi:10.1001/archpedi.1989.02150160063005

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I did not intend to "divorce" innovation from research in my commentary because it is often important in doing research. However, I did try to distinguish innovation and research as two different processes. Recognition of the innovative process, and that innovation is occurring in the clinical setting, is a logical first step in making it safer. Recognition of the hazards of clinical research has resulted in regulations that now make it safer and more ethical. Perhaps similar concepts will evolve regarding innovation.

Like Dr Frader, I am opposed to the "introduction of unproved technologies in the clinical arena" and would extend that to unproved nontechnologic interventions as well. While I remain a proponent of more and better clinical research, I would also like to remain open to advancement of medical care by other means.

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