Fig. 3.

The ‘valley of death’ and the ‘mountains of despair’. The term valley of death has been previously used to describe the chasm between biomedical researchers and the patients who need their discoveries [51]. Here the valley illustrates the disconnection between basic researchers and clinical researchers. Both bench-to-bedside and bed-to-bench bridges are necessary to bridge the gap. However, success in clinical research does not automatically result in improved patient outcomes or preserved health. Two mountains of despair lag between clinical knowledge and patients. The first one involves regulatory and business model issues that may delay marketing of a successful solution. The second one involves education of stakeholders (doctors, healthcare professionals, healthcare decision-makers, patients) and policies that allow widespread implementation of the solution across socioeconomic and geographical barriers. Tunnels are required to sort out these obstacles. The image of a mountain to depict difficulties in implementing technologies that have shown some measure of success in humans was previously used to illustrate the plight of novel biomarkers [52].