Knowledge, Understanding and the Dynamics of Medical Innovation

This paper investigates the processes by which scientific knowledge is created andlegitimized. It focuses on scientific developments in a branch of medicine and exploresthe pathways through which the growth of knowledge enables advances in medicalscience and in clinical practice. This work draws conceptually on evolutionaryapproaches to technological change. The empirical part presents a longitudinalanalysis of a database of scientific publications in the field of ophthalmology over aperiod of 50 years. Such an exercise allows us to identify pathways of sharedunderstanding on a disease area, and to map out distinctive trajectories followed by theophthalmology research community....