Nexus innovation assessment


Muazam S. Iqbal
Staff member
The increase in fundamental knowledge about human health and disease mechanisms was so rapid during the second half of this century that we have often been described as living in a period of biological revolution. In the spirit of Francis Bacon, who observed that the true essence of progress lies in the application of scientific knowledge to improve the human condition, our society in recent decades has evaluated biomedical innovation and its promise to improve health management and diseases. Rapid advances in biomedical research have actually stimulated the development of numerous effective medical technologies, but their translation into clinical use has raised complex medical, economic, and social problems. The emergence of these problems - as illustrated by the development of new drugs for acquired immunodeficiency syndrome (AIDS) - is stimulating a new interest in medical innovation: how it presents itself, what can be expected of it, and how it could be improved.

Technological innovation in medicine covers the wide range of events through which a new medical technology is discovered or invented, developed, and spread in healthcare. One of the most vulnerable links in this innovation chain today is the development phase, the "D" of R&D, where research results are brought into clinical practice. More specifically, the development of medical technology can be defined as a multi-step process through which a new biological or chemical agent, a prototype of a medical device or a clinical procedure is technically modified and clinically evaluated until it is considered ready for general use. Although this definition suggests an organized and systematic process, much development activity actually takes place in an unordered way in daily clinical practice.


Among the many factors that influence development, clinical evaluation criteria and methods have become increasingly important determinants of how - and indeed if - new medical technologies are developed. This first volume of the Institute of Medicine (IOM) Commission for Technological Innovation in Medicine focuses on the interaction between strategies for clinical evaluation and the development of new drugs, devices, and clinical procedures.