Two suggested future strategies for biocompatibility testing of materials. A, The pyramid scheme of Figure 6-6 is retained, but it is acknowledged that primary and secondary tests will play a continuing (but decreased) role as the progress of the testing continues. B, The usage test has the most stature and the most common progression of tests is from primary to secondary to usage, but the need to go through several iterations between testing types is acknowledged. Furthermore, the ongoing nature of biocompatibility is recognized by the need to use primary and secondary tests after clinical evaluation of a material. In this scheme the order of testing is ultimately determined as the testing and clinical use of the material continues to provide new data.