Many clinical research studies, even in the major general medical journals, do not satisfy the identifiable features that make them useful. These features include:
- problem base;
- context placement;
- information gain;
- patient centeredness;
- value for money;
Most clinical research findings false. Further, most of the true findings do not result in huge human benefit. Reform and improvement in the clinical research are overdue.
See also: Peer review: a flawed process at the heart of science and journals by Richard Smith at the Journal of the Royal Society of Medicine
Quoted summary points
Blue-sky research cannot be easily judged on the basis of practical impact, but clinical research is different and should be useful. It should make a difference for health and disease outcomes or should be undertaken with that as a realistic prospect.
Many of the features that make clinical research useful can be identified, including those relating to problem base, context placement, information gain, pragmatism, patient centeredness, value for money, feasibility, and transparency.
Many studies, even in the major general medical journals, do not satisfy these features, and very few studies satisfy most or all of them. Most clinical research therefore fails to be useful not because of its findings but because of its design.
The forces driving the production and dissemination of nonuseful clinical research are largely identifiable and modifiable.
Reform is needed. Altering our approach could easily produce more clinical research that is useful, at the same or even at a massively reduced cost.