Is too much health research - unnecessary, unethical, unscientific, wasteful?
By Bobby Ramakant, Citizen News Service (CNS)
February 20, 2015
The author is the Health Editor at Citizen News Service (CNS) and a World Health Organization (WHO) Director-General’s Awardee 2008
Too much health and medical research may be unnecessary, unethical, unscientific, and wasteful, warns a new global network, 'Evidence-Based Research Network (EBRNetwork)' - initiated by a group of Norwegian and Danish researchers. Researchers, research funders, regulators, sponsors and publishers of research fail to use earlier research when preparing to start, fund or publish the results of new studies, EBRNetwork experts argue. They stress: To embark on research without systematically reviewing evidence of what is already known, particularly when the research involves people or animals, is unethical, unscientific, and wasteful.
At the 'Bergen meeting' partners agreed that the aim of the EBRNetwork is to reduce waste in research by promoting:
- No new studies without prior systematic review of existing evidence
- Efficient production, updating and dissemination of systematic reviews
But is it true that sometimes there is a waste in health and medical research? Yes, says Dr Hans Lund, Chair of the EBRNetwork Steering Group and a senior researcher at University of Southern Denmark. Dr Hans Lund gave an example: A recent publication by Habre, C., et al (BMJ, 2014) concluded after a systematic review that using lidocain before applying a propofol injection is very helpful. This conclusion was based upon no less than 56 trials (including 6264 patients) clearly showing that this was a good procedure. However, a later systematic search for the same kind of studies showed that following the review from 2000, 136 new studies have been performed. Some of them have looked upon other aspects of using the lidocain, but 95 studies after the first review in 2000, was repeating the same studies already synthesized and showing a clear conclusion. This is an example of researchers unnecessary repeating studies already performed. The performed 95 unnecessary studies could be termed "research waste".
Dr Hans Lund shares another example of a "research waste": In a study performed in 2005 by Fergusson et al, looked at more than 60 trials done during 1987-2002 to test whether aprotinin could diminish bleeding during heart surgery or not. A cumulative meta-analysis clearly indicated that after the 12th study the results were clearly in favour of using aprotinin. However, following that 52 further studies were performed giving no new information or changing the conclusion that is also "research waste". In the case with aprotinin maybe more than 2000 patients had suffered side effects or even died because of unnecessary randomisation to placebo.
Indian researcher who is a member of EBRNetwork also reiterate the cause it addresses. Dr Soumyadeep Bhaumik, Executive Editor, Journal of Family Medicine and Primary Care and an EBRNetwork member from India, said to Citizen News Service (CNS): "What the network aims to achieve would mean a tactical shift in the way medical research is conducted and funded globally. It is not that India does not have funds available for medical research but much of what is being funded may be getting wasted and is redundant in nature- and hence no real impact or breakthroughs. Most funding decisions have no objectivity into the way it is evaluated. If all funding decisions and researches are done taking into account methodologically-done and rigorous systematic reviews which determines the current status of knowledge, it would not only mean more efficient use of available resources but also translate into real-term health benefits."
The EBRNetwork now issues a call for interested individuals and organizations to join the EBRNetwork and work together in developing a consensus statement to address this challenge to the very heart and values of research. The EBRNetwork brings together initial partners from Australia, Canada, Denmark, the Netherlands, Norway, the UK, and USA, and was established in Bergen, Norway in December 2014.
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Posted on: February 20, 2015 07:37 AM IST