Between Bench and Bedside: Building Clinical Consensus at the NIH, 1977-2013

After World War II, the National Institutes of Health (NIH) emerged as a major patron of biomedical research. In the succeeding decades, NIH administrators sought to determine how best to disseminate the findings of the research it supported and manage their relationship with clinicians in the national community. This task of bridging research and practice fell to the Office of Medical Applications of Research (OMAR), which administered the NIH Consensus Development Program (CDP) between 1978 and 2012. This article argues that the CDP represented an unusual attempt to depoliticize biomedical research and medical practice at a particularly controversial time in American medicine. Throughout the program's existence, administrators sought ways to bring new knowledge to the medical community without creating the appearance of regulating clinical practice. For an agency with a mandate to promote the production of new biomedical knowledge, the question remained open as to how far this responsibility extended from the bench to the bedside. In striking this balance, the leadership sought to refine their understanding of the role and mission of the NIH. The history of the CDP has much to tell us about postwar biomedical research, health politics, and the institutional development of the NIH.