Only after its widespread use in clinical practice did we learn that reserpine can induce clinical depression in predisposed individuals. Thus, carefully controlled clinical trials, which inevitably reduce the level of heterogeneity in the study population, are likely to conceal important dimensions of the usefulness or limitations of a new technology. The identification of new uses may only be possible after the extensive use of a medical innovation. The history of pharmaceutical innovation is replete with the discovery of new uses after drugs have been introduced into widespread use. The assessment of new indications for existing drugs and devices does not exhaust the contributions of clinical research at academic medical centers.
Research also analyzes the efficacy, safety, and costs of newly emerging clinical interventions.
This is, in fact, a major growth area for research at Columbia's College of Physicians and Surgeons , which has created an Office of Clinical Trials to promote the interface between researchers and private and public funding agencies. These different types of research display quite distinct patterns of funding. Basic laboratory research is primarily funded by the NIH and, with the biotechnology revolution, by various arrangements with industry. Given its strong political support, NIH funding appears to have a rosy future. Clinical trials are heavily supported by industrial moneys, which show no sign of decreasing.