Though molecular and cellular level modeling is the first step in the long of for clinical ladder multiscale modeling translational application, it may be regarded as the critical scale: "Where the rubber meets the road." The idiom from automotive engineering refers to the critical endpoint where all the ancillary engineering -fuel system, chassis, pistons, etc. -is finally tested. In the realm of translation, this point comes when we translate results to the clinical basic research setting.

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... physician (though not the surgeon) intervenes at the molecular scale, using pharmacological agents to alter physiological activity only observed at far higher scales: the macroscopic realms of clinical tests and of signs and symptoms. Given the vast scale gap between molecular treatments and macroscopic outcome, there is enormous difficulty in understanding causal relations, so as to design better drugs and better . Multiscale drug combinations modeling can help make these connections in order to provide a basis for rational pharmacotherapeutics.