From Bedside to Bench: Reverse Engineering Medical Progress

Excerpt

The public expects that, over time, will come new medical advances that add years to our lives, help cure disease, and increase quality-of-life. Less understood is the idea that scientific progress in medicine requires several steps: fundamental discovery (Stage 1); translation of discoveries into clinical relevance (Stage 2); development of practical clinical interventions (Stage 3); and evaluation and refinement of an intervention into practice (Stage 4). All four steps are needed for medical progress to occur (Fig. 1). My thesis is that fundamental discovery is the most critical, since without it none of the other steps are possible. To illustrate this point, I have chosen to discuss the scientific basis of the development of histamine H₂ receptor antagonists (H₂RAs), which at the time of their clinical approval represented a major therapeutic advance for peptic ulcer disease.

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