ABSTRACT

Problem Sequences and Innovation systems: Emergence, Growth and Transformation of a Medical Sector

CRIC Discussion Paper No. 67

A. Mina, G. Tampubolon, R. Ramlogan, L.Venetucci, A. McMeekin and J.S. Metcalfe

Angioplasty is the now dominant surgical treatment for coronary artery disease, which is the most common cause of death in developed countries. The development of this procedure is widely recognised as a milestone in the evolution of medical knowledge in the last thirty years. Not only has it proven to be an effective and efficacious mode of treatment, this innovation brought with it a transformation in the division of labour in cardiology and the birth of a separate sub-speciality of the broader field of cardiology. In this essay, we explore how this new medical technique emerged, developed, diffused and improved over time in the context of a specific micro-innovation system whose nature and structure co-evolved with the growth and transformation of scientific and technical knowledge. To uncover these dynamics, we use new tools recently developed for the longitudinal analysis of large networks. We apply them to a bibliographic database of 11,240 papers published in the area of coronary artery disease between 1979 and 2003 and to a patent dataset of 5,136 US patents documents granted between 1976 and 2003 for angioplasty-related devices. Furthermore, we undertake qualitative reviews of secondary sources, interviews with clinicians, and inspection of product-approval and merger and acquisitions data.

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