How do we know the value of our research?

R esearch is vital to the progress of medicine. Patients depend on it to generate new knowledge that may improve their lives. Clinicians yearn for more effective tools and better guidance for themselves and their patients. Funders seek a substantial return on their investment, often in the form of a contribution to society. Researchers want their work to result in meaningful benefits for others. But how can we gauge the value of the information provided by our research? Some scientists have had the thrill of a breakthrough that definitively eradicates pain and suffering. These researchers, such as Salk and Fleming, have witnessed their efforts result in a fundamental change in the lives of patients. However, for most research, the benefit is less apparent. Perhaps we should be considering the value of information produced by the research. Value of information is an economic concept that quantifies how much we value certain types of information by determining what we might pay for it. We value some types of information highly. For example, we might have been willing to pay an extraordinary amount on September 10, 2001, for information about the following day. How might this concept be relevant to research? A thought experiment may be helpful. In the current paradigm, we generate an idea, develop a proposal, and seek funding. The result is a promissory note with the expectation of results that are worthy of the support. What if we inverted the approach and researchers sold the results of their studies? Like farmers who borrow money to grow crops, the funds would come with the harvest, and the market would determine the price. The research teams that produced knowledge with high value would succeed. Those who produced unwanted knowledge would ultimately need to abandon their efforts. In a system that provides no direct feedback on the value of information that is produced, we may be subsidizing some research above its true value. This approach may maintain the livelihood of people in the field and the capacity in a medi-cal–industrial complex to produce knowledge, but it does not guarantee that the product is needed or valued. Is this approach equivalent to the allocation of farm subsidies that maintain crops that otherwise would not be economically viable? Are we paying for research that could not compete in the value of information marketplace? There are researchers who might say that their unappreci-ated work, like some …