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Entrepreneurial ecosystem researchers generally focus on the few dominant factors affecting entrepreneurship. Insufficient attention has been paid to the interdependencies among regional conditions within an entrepreneurial ecosystem. We focus on the collective effects of factors for regional biomedical entrepreneurship. We use the fuzzy-set qualitative comparative analysis (fsQCA) method to identify sets of regional conditions promoting biomedical entrepreneurship in all 381 U.S. metropolitan areas. The results indicate three configurations contributing to high levels of regional biomedical entrepreneurship: the first one combines public sector biomedical R&D, biomedical patents, and human capital, thus stressing science conditions and related human capital; the second combines public sector biomedical R&D, biomedical patents, clinical trials, and venture capital, thus placing more emphasis on the regional infrastructure sustaining entrepreneurial activity; the third combines private sector biomedical R&D, biomedical patents, human capital, per capita income, population density, and venture capital, thus emphasizing the private sector’s role on boosting regional biomedical entrepreneurship. There is no single recipe for a region to increase its level of biomedical entrepreneurship. 

This paper examines the effect of translational research on knowledge production and biomedical entrepreneurship across U.S. regions. Researchers have earlier investigated the outputs of translational research by focusing on academic publications. Little attention has been paid to linking translational research to biomedical entrepreneurship. We construct an analytical model based on the knowledge spillover theory of entrepreneurship and the entrepreneurial ecosystem approach to examine the relationship between translational research, biomedical patents, clinical trials, and biomedical entrepreneurship. We test the model across 381 U.S. metropolitan statistical areas using 10 years of panel data related to the NIH Clinical and Translational Science Awards (CTSA) program. CTSA appears to increase the number of biomedical patents and biomedical entrepreneurship as proxied by the NIH Small Business Innovation Research (SBIR) grants. However, the magnitudes of the effects are relatively small. Path analysis shows that the effect of translational research on regional biomedical entrepreneurship is not strongly conveyed through biomedical patents or clinical trials.