different things to different people. To the biomedical scientist it could include the crucial basic investigations that lead to a life- and cost-saving vaccine. By contrast, to a hospital's staff ethicist it could entail devising a policy of informed consent for experimental medical treatments. Health-care research, according to many experts, covers the spectrum from fundamental research projects like those in cell biology to such applied questions as how to lower costs yet maintain high-quality service in hospitals.

To evaluate the more applied side of health-care research, the newsletter Science Watch, published by the Philadelphia-based Institute for Scientific Information (ISI), analyzed the publication record over the past 13 years of facilities engaged in this area of endeavor. Using ISI's Science Indicators Database, the newsletter ranked the citation impact of research papers produced at universities, government agencies, and other institutions in such fields as public health, epidemiology, economics, and medical...

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