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- W4242710010 abstract "I appreciate the encouragement regarding our recent efforts to test a device for the prevention of iatrogenic infections.1,2 I also empathize with Dr Muffly et al1 as we walk behind them through the Valley of Death—the paraphrased biblical verse often used to describe the perilous chasm that separates the benchtop from the bedside in translational research. Unfortunately, most new ideas end up “lost in translation” and never make it into clinical use. Many of these fail simply because they lack the support needed to develop them.3 Since research and development resources are generally allocated based on the prospect of success, that is, return on investment, support will be prioritized for innovations that are effective solutions to significant problems. Our first task, therefore, is to convince the larger community that we have a real problem. Research like that of Dr Loftus and Yeager elucidates a pathway of perioperative infection that may involve spread of pathogens from the operating room environment to the patient via our hands and vascular access devices.4,5 However, these novel concepts have yet to make it into mainstream discussion.6 Our second task is to prove that our proposed engineering controls actually help solve the problem. Given the complex pathogenesis of infection, in vitro studies or in vivo studies of intermediate outcomes may be inadequate to convince potential supporters that the devices will ultimately reduce complications in a substantial way. Without clear evidence of significant effect size, it may seem more cost-effective to better implement established solutions than to invest in new ideas with marginal returns.7 There is, of course, a “catch-22” here: we need support to prove the devices’ effectiveness, but we need proven effectiveness to get support. Crossing the divide will require determination and collaboration. Perhaps together, we can reach the other side. David B. Wax, MDMount Sinai School of MedicineNew York, New York[email protected]" @default.
- W4242710010 created "2022-05-12" @default.
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- W4242710010 date "2020-09-01" @default.
- W4242710010 modified "2023-10-17" @default.
- W4242710010 title "In Response" @default.
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- W4242710010 doi "https://doi.org/10.1213/ane.0000000000004973" @default.
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