Bridging the gap between translational medicine and unmet clinical needs.

To date, the actual rate of successful translation has been extremely low although those few successes have been notable and provide for continued and expanding enthusiasm and support. This paper examines whether the fundamental premise may be flawed. Could the success rate be improved to further enhance quality of life and cost optimization for patients by changing the paradigm to "bedside to bench to bedside", and focusing the research on addressing unmet clinical needs? It examines all aspects of the healthcare ecosystem to understand issues that arise with real world patients and in real world clinical practice and how addressing these should be the focus of translational research.