In order to enhance biomedical research and development efficiency and innovation, nontraditional research collaborations have emerged that feature the sharing of information, resources, and capabilities. Although many of these so-called precompetitive collaborations are in the field of oncology, the lessons they offer are broadly applicable to other subfields of translational medicine.by guest on May 12, 2018

Genome sequence data are enabling clinical genomic investigation, in which the characteristics of human patients are explored using comprehensive inventories of biomolecules. Successful investigators must navigate rapid technological change, collect and analyse large volumes of data, and engage systems of clinical care. Such projects will increasingly rely on fully integrated multidisciplinary teams, demanding new organizational models in academic biomedical research.

Physician Fraud and Medicaid Physician Fraud and Medicaid Physician Fraud and MedicaidTo the Editor. \p=m-\Thearticle "Fraud by Physicians Against Medicaid" by Jesilow et al1 is seriously misleading. Its main conclusion, appearing in the abstract, is that "sanctioned physicians show an overrepresentation of psychiatrists, foreign medical graduates, and minority group physicians." The text of the article does not substantiate this conclusion. The authors do not, in fact, provide additional information other that of 138 physicians, sanctioned by Medicaid between 1977 and 1982, slightly more than one third were international medical graduates; blacks and psychiatrists were also overrepresented.The key issue here is the term overrepresentation. As the article stands, it leaves the impression that these minority physicians cheat more than their mainstream counterparts. Representation, however, or representativity, can only be defined with regard to a population. If the population is that of all physicians, then one third of international medical graduates would indeed be disproportionate. It is known, however, that in the population of the providers to Medicaid, whether measured in number of active physicians or in billing amounts, minorities are also overrepresented, perhaps ex¬ tremely so. Thus, the claim of the article is meaningless at best, false and misleading at worst, if not accompanied by comparative data on the proportion of minorities among Med¬ icaid providers.Having failed to substantiate the main specific claim made in the abstract, what is left in the article? That cheaters and lawbreakers usually find excuses and that law enforcers usu¬ ally do not accept them. Unfortunately the JAMA Editorial2 endorses the article the statement: "Fortunately these physicians do not repre¬ sent the mainstream of American medicine." This Editorial elevates what was, in principle, a study of fraud in Medicaid to an identification of "the worst in the profession." It tends to perpetuate the stereotype that it is in the minority groups of professionals where the largest frauds and crimes are committed. There is not even an attempt to compare fraud to Medicaid with that to private insurers or Medicare.Neither the editor nor the authors realize how deeply they have hurt and offended those physicians in the minority groups, which are the ones "overrepresented" in the care of the disadvantaged and the needy of our society.In Reply.\p=m-\Dr Rios makes several excellent points in her letter regarding our article that appeared in JAMA. We strongly agree with her contention that international medical graduates and minority groups are overrepresented among sanctioned physicians because they are overrepresented "in the care of the disadvantaged and the needy of our society." Enforcement agents, were they to investigate physicians accepting private insurance, Medicare, or direct payment, might well find that these physicians offend as often as do minority physicians practicing in poor areas.Psychiatrists are overrepresented among san...