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THIS PRESENTATION deals with what Dr. Jeremiah Stamler called "Levy's arrow" (fig. 1), which depicts the involvement of the National Heart, Lung, and Blood Institute (NHLBI) in the biomedical research continuum. I shall discuss this continuum, together with the role of the NHLBI and its Advisory Council in making assessments, assigning priorities and making allocations. I shall also illustrate its pertinence to meeting society's needs with respect to health and related matters. By using a single Institute program as an example, I will try to show how biomedical research affects the community as a whole and has an impact on social issues and how, in turn, these issues influence biomedical research. I will use the terms knowledge acquisition, knowledge validation and knowledge transfer. However, in the context of NHLBI activities, they are often synonymous with support of basic and clinical research, support of applied research and clinical trials, and support of demonstration and education programs (fig. 2). The arrow may also be considered in terms of the process of innovation itself: idea generation, the communication of new ideas, idea utilization and development, and the diffusion of these ideas, once validated, into general practice.

The National Heart, Lung, and Blood Institute. Overview 1980. The Director's Report to the NHLBI Advisory Council.