Report: Impact of Biomedical Research Slipping

Despite dramatic increases in publications, the last 50 years have seen relatively little return on investment for US public health, a study suggests.

By | August 18, 2015

FLICKR, UNDERSTANDING ANIMAL RESEARCHGiven relatively steady increases in funding (the last 10 years aside) and the number of new papers published each year, the US biomedical research community might expect to see greater outcomes over the past half century—in terms of the numbers of new drugs approved, for example, or gains in life expectancy. But, according to a study published yesterday (August 17) in PNAS, the amount of science being done has not directly translated into public-health benefits.

“The idea of public support for biomedical research is to make lives better. But there is increasing friction in the system,” coauthor Arturo Casadevall, a microbiologist at Albert Einstein College of Medicine in New York City, said in a press release. “We are spending more money now just to get the same results we always have, and this is going to keep happening if we don’t fix things.”

Casadevall teamed up with Anthony Bowen, an MD/PhD student at Johns Hopkins Bloomberg School of Public Health in Baltimore, to compare the “inputs” and “outputs” of biomedical science, such as annual National Institutes of Health budgets and publication numbers, with outcomes such as drug approvals and life expectancy since 1965. What they found didn’t quite add up. While NIH budgets grew exponentially for 40 years (before leveling off) and annual publications grew sixfold over the entire time period (while the number of authors grew ninefold), the number of new drugs approved by the US Food and Drug Administration has increased little more than twofold and life expectancy has grown steadily at just two months per year.

“There is something wrong in the process, but there are no simple answers,” Bowen said in the release. “It may be a confluence of factors that are causing us not to be getting more bang for our buck.” These factors may include the pressure to publish high-impact papers, which could motivate researchers to cut corners or hype their results, and a rise in irreproducible studies, due to negligence or outright fraud.

“Our results are best interpreted as a cautionary tale,” Bowen and Casadevall wrote in their paper, and should “motivate new efforts to understand the parameters that influence the efficiency of science and its ability to translate discovery into practical applications.”

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Avatar of: dumbdumb

dumbdumb

Posts: 94

August 18, 2015

set aside the evidence that the scientific world has become totally disfunctional and wasteful, the assumption that by doubling the investement and pubblications you should double the benefits in a linear fashion is simplistically moronic. It is like expecting that by doubling the power of a car it will go twice as fast

Avatar of: Jakepgh

Jakepgh

Posts: 2

August 19, 2015

Almost ALL the metrics used in that paper are flawed. Where is it written that the number of new drugs is a reasonable measure of success? And counting publications as a proxy for productivity is one of the most egregious developments in science over the past 50 years. The connections between basic research and outcomes are difficult to extract, and are always lagged, sometimes by decades. Public health outcomes are also affected by many non-scientific factors, including almost certainly the growing level of economic inequality. (See Wilkinson & Pickett, The Spirit Level, 2009)

The Scientist should be able to do a much better job at CRITICAL evaluation of a paper like this, rather than simply retelling the much-disputed claims of this paper.

Avatar of: MarkAT216

MarkAT216

Posts: 1

August 19, 2015

Agree with "dumbdumb".  This argument of linear (exponential) growth does not compute.  And an increase in life expectancy of 8.33 years (50 yrs X 2 months/yr = 100 months;  100/12 = 8.333) over the span of 50 yrs does not seem inconsequential to me.

Avatar of: Zafar Iqbal, PhD

Zafar Iqbal, PhD

Posts: 9

August 19, 2015

It is naive to expect exponential increase in life expectancy in relation to money spent on biomedical research.  It is not like addiing more sugar will make your drink sweeter.  I believe the main goal of medical research is to improving the health, not necessarily prolonging life.  Anyway what should be the target of human life span? 

Avatar of: RHE

RHE

Posts: 1

August 19, 2015

A clueless paper.  An inappopriate metric.  An invalid interpretation,

What was PNAS thinking?

Avatar of: Allen A. Smith

Allen A. Smith

Posts: 2

August 19, 2015

One should expect  the marginal cost of each new improvement to increase.  The cheap and easy problems have been solved.  Even some hard problems have been solved.  What remains are very hard and very expensive problems. 

Avatar of: Paul Stein

Paul Stein

Posts: 237

August 19, 2015

I have to agree with the basic conclusion that there has been relatively little return on investment, maybe not for the past 50 years, but definitely for the past 30.  I've been going to the annual FASEB-Experimental Biology meetings for over three decades, and it is remarkable how little basic physiology has progressed in that time since I received my doctorate.  It's "nothing new" year after year after year.  Certainly, a few hot topics have come and gone, but for all that money, the physiology textbooks of 1985 are just as timely as those in 2015.

The so-called experts at the NIH, and others, have convened their reviews of the research enterprise many times over the years, and have never come up with any sorts of logical fixes.  There are lots of issues to blame, and anyone can pick their pet peeve, but the system is quite rotten to the core, and there needs to be a new group to produce a change for the better. 

Avatar of: artmez

artmez

Posts: 10

August 19, 2015

Or maybe it just hit a plateau due to a confluence of events like:

  1. research has gotten most of the low-hanging fruit (i.e. the easy stuff), so what's left is more difficult
  2. the decline (at least in the US) of students deciding to go into scientific fields (not to mention the escallating cost of college)
  3. there are more hoops (regulations) to jump through to get anything done now than a couple of decades ago
  4. as you pointed out, goverenment funding has been on the decline, in not small measure due to politics

Maybe this is also like the problem with ISO-9000 process improvement, as that process, in practice, does not include the means to determine when good enough is really "good enough". To put this in the current context -- are we really getting worse, or are our expectations too high?

Avatar of: James V. Kohl

James V. Kohl

Posts: 481

August 19, 2015

“There is something wrong in the process, but there are no simple answers,”

Pseudoscientists never learned how cell type differention occurs in the context of nutrient dependent biophysically contrained protein folding chemistry. They failed to link RNA-mediated gene duplication and the fixation of amino acid substitutions to cell type differentiation via the physiology of reproduction in all genera.

But see: From Genome Research: Genome-wide annotation of primary miRNAs reveals novel mechanisms

Next, serious scientists will realize that viral microRNAs cause all pathology.

Watch for that news to be reported here, too.

Avatar of: Neurona

Neurona

Posts: 71

August 19, 2015

The drug-device system is one of perverse incentives that rewards "me-too" type  development and medicalization, rather than new approaches.

One would also expect asymptotic changes in life expectancy given the powerful social forces that SHORTEN it (shift work, pollution, sugar addiction, socioeconomic stress, war).  There's only so much that treatment can do. 

Finally, shouldn't quality of life improvements thanks to research be a measure here?  I'd rather die a spry 80 years old than live an extra 20 years in a bed.  

Avatar of: Eric J. Murphy

Eric J. Murphy

Posts: 20

August 19, 2015

Intersting points, but some really critical questions that from the brief synopsis my have not been addressed.  1).  What is the lag between the type of research funded by NIH and the pharmaceutical industry?  2).  How did the shift in NIH funding of more basic research to more disease oriented research impact real outcomes?  3).  What impact has the increased aversion to risk had on the funding of high risk, high yield projects?  4).  Has a lot of the low hanging fruit been picked to that the gains from here on out will be more incremental in nature? 

Just a few thoughts.

Avatar of: Eric J. Murphy

Eric J. Murphy

Posts: 20

August 19, 2015

Intersting points, but some really critical questions that from the brief synopsis my have not been addressed.  1).  What is the lag between the type of research funded by NIH and the pharmaceutical industry?  2).  How did the shift in NIH funding of more basic research to more disease oriented research impact real outcomes?  3).  What impact has the increased aversion to risk had on the funding of high risk, high yield projects?  4).  Has a lot of the low hanging fruit been picked to that the gains from here on out will be more incremental in nature? 

Just a few thoughts.

Avatar of: Zafar Iqbal, PhD

Zafar Iqbal, PhD

Posts: 9

August 20, 2015

During Clinton administration NIH budget increased and attracted biomedical researchers. Situation changed later forcing "bright" students to look for other avenues to express their talents and also more reliable employment.

Has anyone data available showing amount of funds allocated for research as percentage of national GDP during the period (last 50 years) the author of the article has analyzed and suggested less than expected return on investment for US public health?

Avatar of: hxl

hxl

Posts: 3

August 20, 2015

Informative post with a special perspective.  I will share it to my teacher later.

Avatar of: Allen A. Smith

Allen A. Smith

Posts: 2

August 24, 2015

It is hardly surprising that the cost of scientific advances is increasing.  The cheap and easy work has already been done.

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