{"doi":"10.1016/j.jvsvi.2024.100115","title":"The place of venture philanthropy in vascular surgery discovery and invention","abstract":"Discovery and invention are the engines that promote advances in medical science. In discovery, we find or uncover something already in existence but unknown or previously unrecognized. In invention, we create something new. Sometimes discovery and invention complement each other: the invention of the microscope opened immense possibilities to discover worlds until then unknown. Discovery begins when an investigator sees something that, as Nietzsche said, “has no name as yet and hence cannot be mentioned although it stares us all in the face.” The successful scientist thinks like a poet, as he guesses a new relationship between two things that were thought to be unlikely. This is not a mere metaphor. Carlo Rovelli—a physicist who works on quantum gravity—put it this way: “Perhaps poetry is another of science's deep roots: the capacity to see beyond the visible.” It is no surprise that money is relevant to both discovery and invention. In the former, unencumbered financial support may allow a medical scientist with an endowed position to have protected time to think and work beyond conventional boundaries, where something never heard of may be found. Similarly, invention invariably requires financial backing to create and often test something that is new. Contemporary funding of medical inventions comes most often from industry, and less often from grants from both public and private organizations, like the National Institutes of Health (NIH) or the American Heart Association. I believe a different source of funding from venture philanthropists, who are private investors, is an underappreciated source of important funding to advance medical discovery and inventions. Venture philanthropy, similar to industrial support, represents an investment with an anticipated return to the donor. It is particularly popular with adventurous oriented donors who support high-risk discovery or transformative creation, that potentially will have a major impact, both financially and scientifically. Many of the world's greatest discoveries and inventions have resulted from mechanistic inductive interventions. And I stress mechanistic because historically technological advances have usually preceded scientific studies. For example, Chinese fireworks of 2000 years ago inspired the chemical experimentation of propellants used first in cannons and more recently in rockets and missiles. The theory of engineering hydraulics arose from the experience 250 years ago of constructing elaborate palace fountains to please their royalty owners, and shortly thereafter, the development of steam engines spurred the elaboration of the fundamental laws of thermodynamics. In our vascular surgery field, several technical clinicians dismantled well-established but false scientific theories, like the role of vasospasm in causing transient ischemic attacks or the belief that an intact intima was required for an artery to not thrombose. The former followed the radiographic recognition in the early 20th century, of potential embolization of particles from an arteriosclerotic plaque in the carotid artery bifurcation, and the latter was proven wrong when surgeons in the 1950s implanted Nylon grafts in man and established that a synthetic arterial conduit would function without an endothelial lined intima. Inductive thought, the leading candidate for human intelligence, allows us to reach big conclusions based on very little data. Deductive thought operates afterward to verify the mechanism suggested by induction. So, in the process of discovery or invention, there are two phases: an inductive one during which a new solution to a problem is thought and tried, and a deductive phase when a formal statistical analysis verifies the correctness of the assumption. Although the NIH is the world's largest funder of medical science, the most important medical and surgical discoveries in the last 25 years have not resulted from academic research done under NIH sponsorship. An exception ","journal":"JVS-Vascular Insights","year":2024,"id":500410,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.955,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1350068,"name":"Ramón Berguer","orcid":null,"position":0,"is_corresponding":true}],"reference_count":0,"raw_metadata":null,"created_at":"2026-07-19T02:10:08.435215Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}