Translation of highly promising basic science research into clinical applications

PURPOSE: To evaluate the predictors of and time taken for the translation of highly promising basic research, into clinical experimentation and use. METHODS: We identified 101 articles, published between 1979 and 1983 in six major basic science journals, which clearly stated that the technology studied had novel therapeutic or preventive promises. Each case was evaluated for whether the promising finding resulted in relevant randomized controlled trials and clinical use. Main outcomes included the time to published trials, time to published trials with favorable results ("positive" trials), and licensed clinical use. RESULTS: By October 2002, 27 of the promising technologies had resulted in at least one published randomized trial, 19 of which had led to the publication of at least one positive randomized trial. Five basic science findings are currently licensed for clinical use, but only one has been used extensively for the licensed indications. Promising technologies that did not lead to, a published human study within 10 to 12 years were unlikely to be tested in humans subsequently. Some form of industry involvement in the basic science publication was the strongest predictor of clinical experimentation, accelerating the process by about eightfold (95% confidence interval: 3 to 19) when an author had industry affiliations. CONCLUSION: Even the most promising findings of basic research take a long time to translate into clinical experimentation, and adoption in clinical practice is rare. Am J Med. 2003; 114:477-484. (C) 2003 by Excerpta Medica Inc.