Adoption of protocols to improve quality of medical research

Abstract

The primary means of dissemination and sharing of scientific research results are publications in specialized journals. The quality and relevance of the investigation are assessed, among others, by the material that was published, which is usually the single public register of the research. Problems in this communication hinder the correct evaluation of a study and limit its effectiveness. Such a situation becomes critical becomes critical in a research field such as the health sciences, since it allows wrong decisions to me made by professionals, and consequently, a real potential of harm to the patients. (1) Medical science requires evidence to identify problems, evaluate the accuracy of the diagnoses or prognoses, compare and assess interventions, describe their adverse or rarest effects, evaluate if an early detection test is really necessary, as well as how to compare intervention costs, among so many other factors. Scientific evidence is produced by means of several experimental approaches and, in general, but not only, by adopting study formats, such as observational studies, randomized studies with intervention, case reports, systematic reviews with meta-analysis, and the opinion of specialists. (2) The strength, power, or level of evidence in health depends on how this evidence was generated. One form of representation proposed for this evaluation is called pyramid of evidence (Figure 1). This scheme relates research designs with the types of data generated for which the levels of evidence are proposed. At the peak of the pyramid, there are metaanalyses, followed by systematic reviews and randomized clinical trials. The meta-analyses were conceived, initially, as a tool to incorporate robustness into the evidence generated by the randomized clinical trials, for allowing aggregation and comparison of results from independent studies about the estimation of effect sizes of a given intervention. Thus, they enable the clarification of questions derived from independent research, since they expressively widen the sample of investigated subject through data synthesis. Since they are able to provide precise responses, they are considered the studies with the highest level of evidence. (3) The base of the naturally will have a large amount of data. Typically, there are the shorter, more restrictive studies with limited resources, that have smaller samples or with less restrictive methodological demands than the randomized clinical trials. These are the generically called observational studies, which can be case-control, cohort, ecological, and interventional. They have various origins, but can be, for example, those derived from graduate dissertations and theses. One the other hand, when taken as a How to cite this article: Montagna E, Zaia V, Laporta GZ. Adoption of protocols to improve quality of medical research. einstein (São Paulo). 2020;18:eED5316. http://dx.

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