Medical hypotheses
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Most research is 'normal science' using Thomas Kuhn's term: checking, trial-and-error improvement and incremental extrapolation of already existing paradigms. By contrast, 'revolutionary science' changes the fundamental structures of science by making new theories, discoveries or technologies. Science Nobel prizes (in Physics, Chemistry, Physiology/Medicine and Economics) have the potential to be used as a new metric for measuring revolutionary science. ⋯ Although Nobel science prizes are sporadically won by numerous nations and institutions, it seems that long term national strength in revolutionary science is mainly a result of sustaining and newly-generating multi-Nobel-winning research centres. At present these elite institutions are found almost exclusively in the USA. The USA is apparently the only nation with a research system that nurtures revolutionary science on a large scale.
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A priori hypotheses are considered a cornerstone of the scientific method. A posteriori hypotheses, on the contrary, are judged by many as inappropriate and are hardly ever acknowledged as such. Such practice is inadequate. ⋯ And yet, their unambiguous formulation in the study publication can enable others to follow up on the findings and the modified conjectures fast and thus facilitate scientific progress. In this vein, a posteriori hypotheses should be encouraged as a thinker's prime tool rather than be discouraged. Indeed, it is suggested, that information on a posteriori hypotheses should be formally required when research is published.
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Editorial
Mega-prizes in medicine: big cash awards may stimulate useful and rapid therapeutic innovation.
Following Horrobin's suggestion of 1986, I argue that offering very large prizes (tens of millions of US dollars, or more) for solving specific therapeutic problems, would be an excellent strategy for promoting the rapid development of effective new treatments. The two mainstream ways of paying for medical research are funding the process with grants or funding the outcome via patent protection. When grants are used to fund the process of research the result tends to be 'pure' science, guided by intrinsic scientific objectives. ⋯ For example, medical charities focused on specific diseases should consider accumulating their resources until they can offer a mega-prize for solving a clinical problem of special concern to their patients. Prize money should be big enough to pay for the research and development, the evaluation of the new treatment in a clinical trial, and with a large profit left-over to compensate for the intrinsic risk of competing. Sufficiently large amounts of money, and the prestige and publicity derived from winning a mega-prize, could rapidly mobilize research efforts to discover a whole range of scientifically un-glamorous but clinically-useful therapeutic breakthroughs.