The second part of Chris’ post. Just the thing to start discussions over Friday lunch. Remember Bec’s tips though, forget about it before you head to the bar tonight!
Always the afterthought, another consequence of producing large quantities of research is regarding dollars (or € or £).
Conducting a clinical trial is expensive and is an obvious waste of resources in the case of high volumes of poor research. Big piles of poor research also add unnecessary pressure to overextend peer review and require additional resources to synthesize evidence for systematic review and guideline development. However, trial quality does not have to be poor to have wasted the funding and resources required to conduct the research.
Should a trial of an intervention that is not expected to be more effective (or cost effective) than current usual care or recommend practice go ahead? Unfortunately this outcome is often the case and maybe should be considered before we conduct our research. In my view, an impressive mission statement (e.g. to reduce the burden of disease) and the usual statistics about the significant burden of a disease do not of themselves justify the conduct a trial (of a certain intervention). Surely, with competing interests for the public purse, when research is publically funded we require…. (deep breath)…. greater regard to the expected benefit relative to costs of the proposed solution (including the cost to conduct a trial) and compared to existing options.3 I wonder how many current and previous studies would have passed this test before they were sent off for funding.
I have considered only a few of the consequences of conducting excessive (and not just poor quality) research. An obvious flaw in the scientific process is to disregard the adverse impact of our work and focus on the positive implications. We must be careful that this does not lead us astray, if it hasn’t already.
3 – Torgerson DJ, Byford S – Economic modelling before clinical trials BMJ 2003; 325: 98 http://www.bmj.com/content/325/7355/98.1.full
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