Translation lag-adjusted biomedical research efficiency, as measured by outcomes ÷ outputs and outcomes ÷ inputs. Publication number, scientist number, and NIH budget are adjusted with a translation lag of 15 y. (A–C) NMEs produced each year divided by translation lag-adjusted units of new knowledge (A), scientific authors (B), and NIH funding (C) relative to 1965 levels. (D) The cumulative number of NMEs produced since 1980 divided by translation lag-adjusted cumulative biomedical knowledge is shown from 1980 to 2014.