FIGURE 6-1 Pathway of medical technology development.

This chapter describes the stages of technology development and considers the degree to which there are obstacles that cause unreasonable delays and proposals for reducing those obstacles. Avoidable pitfalls, such as clinical studies designed so poorly that they fail to provide clear answers or technologies developed with little understanding of what physicians and patients really need, are also covered. The development of medical technologies is a complex enterprise that requires the integrated expertise of engineers, biologists, physicians, statisticians, and health care administrators. This chapter thus highlights a variety of initiatives that illustrate different approaches to integrate the necessary expertise for innovations that save lives.

SUPPORT FOR DISCOVERY RESEARCH IS ADEQUATE

Fostering the invention and early stage development of medical technology is essential and depends on the nurturing of basic medical research. Due in no small part to the long-standing and tireless efforts of breast cancer activists, breast cancer research has been generously supported over the past few decades. With the possible exception of AIDS, breast cancer research receives more funding than any other disease. The National Cancer Institute (NCI) currently supports more research projects and clinical trials for breast cancer than for any other type of cancer.51 According to their website, NCI supports 2,932 breast cancer projects and 112 clinical trials. By comparison, the average for all 56 types of cancer (or aspects of cancer) listed by NCI is only 276 projects and 8 clinical trials. In addition to



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