Series addresses widespread waste, poor value in science
Biomedical research is rife with waste and changes are needed to improve research efficiency, dissemination and transparency of new knowledge, along with more effective translation of findings into clinical practice, a series of recently published articles in The Lancet contend.
Michael B. Bracken, Susan Dwight Bliss Professor of Epidemiology at the Yale School of Public Health and one of the authors of the five-part series, said that while the biomedical research community currently provides a huge amount of benefit to society, it does so in spite of a high degree of wasted, unnecessary research.
“This series documents how much more could be accomplished if we substantially improved the efficiency of the research enterprise,” he said.
The first article emphasizes the large amount of dollars spent on research with too little to show for return on the investment. In 2010, $240 billion dollars were spent on research worldwide. However, many funded research projects do not provide helpful results or information to the medical research communities and their patients. There is a substantial need to improve basic research methods, provide greater transparency for how funding decisions are made in light of existing evidence, and how in-progress research could be made more available to researchers and funders alike. More attention should be paid to asking research questions of interest to patients and users of research. Funding institutions and governments and their advisors are ultimately responsible for reducing monetary waste by making well-informed decisions about which projects to fund or not.
The second article points to the potential for misleading results and biases in research design, which can lead to wasting valuable resources. Poor documentation, low statistical precision, disregard for previously conducted studies, and failure to involve statisticians and properly train laboratory staff in research design, are all factors that can lead to inefficient assignment of labor, effort, time and money. Further, the current reward systems, at the institutional level, emphasize quantity over quality and novelty over reproducibility, which can produce an imbalanced picture of how research should be conducted.
The third paper in The Lancet series addresses waste arising from overregulation and management of research. Regulators should review other causes of waste in research rather than micromanaging research under the assumption that it is in the best interest of participants and patients. Laws and regulations, particularly related to ethics committees who are overly concerned about low-risk projects, should be streamlined to provide guidance on how research should be done while not impeding research efforts. Efficiency in recruitment, retention, and data monitoring and sharing should be set as priorities. Administrators and managers of healthcare systems should also promote integration of research results into clinical practice.
The fourth article elaborates on the need for better publishing of methods in study protocols. Protocols and detailed study reports are rarely available and when they are provided, the quality of reporting is variable. The authors suggest improvements where funders and institutions should reward researchers who fully disseminate their research protocols, reports, and datasets. Further, they suggest that all health research should have standards for content and that pre-registration of studies be mandatory.
The final article in the series considers waste from incomplete or unusable reports of biomedical research, the current methods and standards for reporting research. Although reporting guidelines such as CONSORT, STARD, PRISMA, and ARRIVE have been developed, these are not followed consistently or widely. The current guidelines aim to organize content and clarify research conducted. More specifically, to outline which research questions were posed and why, what was done to obtain answers, and what the findings may mean. A change in the current system of research rewards is warranted to encourage better reporting as well as developing a funded infrastructure to maintain better reporting practices, and to archive all elements of research for future analysis.