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The Trajectory of Discovery: What Determines the Rate and Direction of Medical Progress?

The Trajectory of Discovery: What Determines the Rate and Direction of Medical Progress?

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Medical research works in trajectories. Scientists and researchers must choose to pursue certain scientific pathways and omit others, limited by resources, attention, and time. The trajectory of medical progress is therefore characterized by two crucial characteristics:: rate and direction. These two components form the foundation for this book - what are the forces that determine the rate and direction of progress in medicine? This book brings together the worlds of scientific policy, economics, sociology, philosophy, and innovation to describe why the world of medical research looks the way it does. The book also addresses fundamental contemporary issues in medicine, how they influence progress, and how we might improve medical research going forward. The contemporary issues discussed include:: flawed incentive structures, a concentration of power and resources among few actors and disease groups, the potential distortionary effects of lobbying by different scientific actors, and missing novelty in drug development.
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  • Part I. Incentives, Context and Capital: 1. Citations as currency; 2. Hacking statistics; 3. The allure of prizes; 4. Streetlight effects; 5. Patented and regulated progress; 6. Teams and diversity; Part II. The Financial Determinants of Discovery: 7. The research marketplace; 8. Winners take all; 9. Public service; 10. The medici model; 11. The goldilocks zone; 12. Kindling creativity; Part III. Bending the Arc: 13. Lobbying for change; 14. Scientific elasticity; 15. Death of a star // new kids on the block; 16. Great emergencies; 17. Fraudulent findings; 18. Serendipity; 19. Converging paths; Part IV. Reflecting on the Trajectory: 20. Civic engagement; 21. Uncertainty; 22. Commercialization and power; 23. Morality and progress.
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