Research waste is still a scandal—an essay by Paul Glasziou and Iain Chalmers

Glasziou, Paul; Chalmers, Iain

doi:10.1136/bmj.k4645

Cited by 193 publications

(188 citation statements)

References 20 publications

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“…This lack of consideration of external validity in individual trials also has implications for meta‐analysis, particularly if high‐risk participants or those with poorer prognosis are included . Effective use of external validity has the potential to improve implementation of appropriate interventions and avoid the use of efforts that are not worthwhile, thereby optimizing patient outcomes and reducing research waste …”

Section: Discussionmentioning

confidence: 99%

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External validity of randomized controlled trials of interventions in venous leg ulceration: A systematic review

Gethin

Ivory

Connell

et al. 2019

Wound Repair Regeneration

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We set out to evaluate quality of reporting of data related to external validity from randomized controlled trials (RCTs) assessing treatment interventions for active venous leg ulcers. Using a systematic review study design, we identified 144 full‐text RCTs of treatment interventions, where the wound was assessed and published in English from 1998 to 2018. We found that the median study sample size was 75.5. Weighted mean wound size was 13.22 cm2 and weighted mean wound duration was 22.20 months. Forty‐six (32%) reported numbers screened for eligibility and 27 (19%) reported the number who declined to participate; 19 (13%) reported on patient ethnicity; 60 (42%) reported comorbidities; and 5 (4%) reported current medication use. When reported, 60/102 (59%) excluded patients with an ankle‐brachial pressure index <0.8; 68/135 (50%) were conducted in Europe, 6/135 (4%) in Asia, and 74/104 (71%) were conducted in outpatient facilities; 3 (2%) reported socioeconomic factors and 88 (61%) reported on adverse events. We concluded that there is inadequate reporting of data related to external validity in reports of RCTs assessing venous leg ulcers treatment interventions. Significant variability exists in the ankle‐brachial pressure index cutoff point for inclusion or exclusion, making generalizability difficult to assess.

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Section: Discussionmentioning

confidence: 99%

“…35 Effective use of external validity has the potential to improve implementation of appropriate interventions and avoid the use of efforts that are not worthwhile, 19 thereby optimizing patient outcomes and reducing research waste. 36…”

Section: Discussionmentioning

confidence: 99%

External validity of randomized controlled trials of interventions in venous leg ulceration: A systematic review

Gethin

Ivory

Connell

et al. 2019

Wound Repair Regeneration

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“…In 2009, Chalmers and Glasziou [55] estimated that 85% of all health research is being avoidably "wasted". Whilst it can be argued that progress has been made, over the last decade, Glasziou and Chalmers more recently [56] claimed that health service research still has a have a long way to go, with continued concerns over research design, conduct and reporting. When analysing the priority areas identified, it is important to be cognisant of these concerns and ensure that the palliative care research projects to address these priorities are of sufficient quality and rigour to address and mediate such concerns.…”

Section: What Is Already Known and What Does This Review Addmentioning

confidence: 99%

International palliative care research priorities: A systematic review

Hasson¹,

Nicholson

Muldrew³

et al. 2020

BMC Palliat Care

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Background: There has been increasing evidence and debate on palliative care research priorities and the international research agenda. To date, however, there is a lack of synthesis of this evidence, examining commonalities, differences, and gaps. To identify and synthesize literature on international palliative care research priorities originating from Western countries mapped to a quality assessment framework. Methods: A systematic review of several academic and grey databases were searched from January 2008-June 2019 for studies eliciting research priorities in palliative care in English. Two researchers independently reviewed, critically appraised, and conducted data extraction and synthesis. Results: The search yielded 10,235 articles (academic databases, n = 4108; grey literature, n = 6127), of which ten were included for appraisal and review. Priority areas were identified: service models; continuity of care; training and education; inequality; communication; living well and independently; and recognising family/carer needs and the importance of families. Methodological approaches and process of reporting varied. There was little representation of patient and caregiver driven agendas. The priorities were mapped to the Donabedian framework for assessing quality reflecting structure, process and outcomes and key priority areas. Conclusions: Limited evidence exists pertaining to research priorities across palliative care. Whilst a broad range of topics were elicited, approaches and samples varied questioning the credibility of findings. The voice of the care provider dominated, calling for more inclusive means to capture the patient and family voice. The findings of this study may serve as a template to understand the commonalities of research, identify gaps, and extend the palliative care research agenda.

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“…These illustrative examples demonstrate the vast range of discussions which are happening, and need to happen to help us transform how we produce and use evidence. We are not the first to identify the problems of research wastage (Glasziou and Chalmers, 2018) or to emphasise the need to maximise the value of research for society (Duncan and Oliver, 2017). Nor are we the first to note that all the parts of the research system play a role achieving this, from funding (Geuna and Martin, 2003), to research practices (Bishop, 2019;Fransman, 2018), to translational activities Nutley and Tseng, 2014), professional science advice (Doubleday and Wilsdon, 2012) and public and professional engagement (Holliman and Warren, 2017).…”

Section: Next Steps and Concrete Outputsmentioning

confidence: 99%

“…Firstly, we must understand who is involved in shaping and producing the evidence base. Much has been written about the need to produce more robust, meaningful research which minimises research waste through improving quality and reporting (Chalmers et al, 2014;Glasziou and Chalmers, 2018;Ioannidis, 2005), and the infrastructure, funding and training which surround knowledge production and evaluation have attracted critical perspectives (Bayley and Phipps, 2017;Gonzalez Hernando and Williams, 2018;Katherine Smith and Stewart, 2017). Current discourses around 'improving' research focus on making evidence more rigorous, certain, and relevant; but how are these terms interpreted locally in different policy and practice contexts?…”

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confidence: 99%

Transforming evidence for policy and practice: creating space for new conversations

Oliver

Boaz

2019

Palgrave Commun

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For decades, the question of how evidence influences policy and practice has captured our attention, cutting across disciplines and policy/practice domains. All academics, funders, and publics have a stake in this conversation. There are pockets of great expertise about evidence production and use, which all too often remains siloed. Practical and empirical lessons are not shared across disciplinary boundaries and theoretical and conceptual leaps remain contained. This means that we are not making the most of vast and increasing investment in knowledge production. Because existing lessons about how to do and use research well are not shared, funders and researchers are poorly equipped to realise the potential utility of research, and waste resources on-for exampleineffective strategies to create research impact. It also means that the scarce resources available to study evidence production and use are misspent on overlynarrow or already-answered questions. Patchy and intermittent funding has failed to build broadly relevant empirical or theoretical knowledge about how to make better use of evidence, or to build the communities required to act on this knowledge. To transform how we as a community think about what evidence is, how to generate it, and how to use it well, we must better capture lessons being learned in our different research and practice communities. We must find ways to share this knowledge, to embed it in the design of our research systems and practices, and work jointly to establish genuine knowledge gaps about evidence production and use. This comment sets out one vision of how that might be accomplished, and what might result.

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Research waste is still a scandal—an essay by Paul Glasziou and Iain Chalmers

Abstract: Progress has been made towards reducing the 85% of wasted effort in medical research—and the huge amounts of money misspent and harm caused to patients—but there’s still a long way to go, say Paul Glasziou and Iain Chalmers

Cited by 193 publications

References 20 publications

External validity of randomized controlled trials of interventions in venous leg ulceration: A systematic review

External validity of randomized controlled trials of interventions in venous leg ulceration: A systematic review

International palliative care research priorities: A systematic review

Transforming evidence for policy and practice: creating space for new conversations

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