I was surprised when I did my 2008 family medicine board exams...
Gordon's Notes 2008: Challenges to medicine and science – medication invention hits a brick wall
... To put it delicately, progress has sucked. If you put a good physician to sleep 7 years ago, and woke her up today, she’d be reasonable competent on day one. A week later she’d be fully up to speed ...
Sure, there were lots of new drugs, but they were mostly incremental improvements. Medicine got stuck around 1984. Smolin claims physics is just as bad. Now people are writing books about the "Great Stagnation".
This is good. The first step to getting out a rut is to stop spinning wheels. Even better, scientists are doing meta-science on this problem ...
Biologists Ignoring Low-Hanging Fruit, Says Drug Discovery Study - Technology Review
The entire set of kinases in a given organism is called its kinome. The human kinome consists of 518 kinases. Unsurprisingly, biologists and pharmaceutical companies are intensely interested in understanding how these enzymes work and developing drugs that control their behaviour.
So it may come as a surprise to find that three quarters of the research in this area focuses on just 10 per cent of these enzymes, as measured by the number of times the kinases are cited in research papers. By contrast, 60 per cent of the kinome, some 300 kinases, is virtually ignored by the community and mentioned in only 5 per cent of the work.
This is known as the Harlow-Knapp effect after the researchers that discovered it a couple of years ago. The question it raises is why biologists ignore most of the kinome when there is good reason to think that careful study should pay off in silver dollars
Today, Ruth Isserlin at the University of Toronto in Canada and a few buddies take a more detailed look at the effect. They say it is more widespread than previously thought and also affects the study of other biological molecules too....
... One common idea is the Matthew effect--from the biblical reference that the rich get richer and poor get poorer. For example, it is common for well-known scientists to be awarded prizes, making them more famous, even if all the work was done by a graduate student who is ignored.
At first glance, it's easy to imagine that the Harlow Knapp effect is good example of this. Isserlin and co point out that current molecular biology is so rich that it is possible to ask important questions even of the most well-studied systems. And since its easier to get grants, to do good science and to get published in higher impact journals by sticking to well known systems, that's exactly what scientists do. So the best known systems become better studied.
That alone might explain this distribution. But there is something else going on too, say Isserlin and co. Biologists commonly screen the entire genome of an organism looking for interesting proteins. But when they find one, the amount of work they can do with it depends on the chemical tools available to interact with it.
In many cases, these tools are not available. And when that happens, the proteins are ignored. This, say Isserlin and co, is one of the important underlying reasons why so many kinases and other interesting biomolecules are so poorly studied...
Some good clues there, but we should look also into other domains of historic stasis. Music and art have gone through periods of stagnation and renaissance. So has religion ...
... Around the Godde there forms a Shelle of prayers and Ceremonies and Buildings and Priestes and Authority, until at Last the Godde Dies. Ande this maye notte be noticed... [1]
"Priestes and Authority"? Sounds like the NIH.
So we've recognized the problem. How do we get out? It might be we'll get unstuck any minute now, but this is a good time to rethink how we fund and reward scientific endeavor. Should we be doing more prizes for discoveries instead of grants for research? Should we declare certain domains "boring" and off limits for NIH funding? Should we accelerate the demise of tenure?
I expect we're going to hear some interesting ideas over the next couple of years.
[1] Terry Pratchett, Small Gods. Famous scholarly work. In some circles anyway. Ok, so I just like the book.
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